2010

              Run For The Islands 5K & 1 Mile

           Due to the weather the race has been postponed and rescheduled

                                                      New Date

                                March 27, 2010         

                                                  The Islands Community Center

                                               825 S. Islands Dr. - West Gilbert, AZ

                                         (SW Corner of Warner Rd. & Islands Dr.)

 

                                               Registration Starts @ 7:30 a.m.

                  1 Mile Family Fun Run/Walk Starts @ 8:15 ~  5K Starts @ 8:30

                                                   Kids 100 Yard Dash 9:30 a.m.

                                        Pancake Breakfast & Beach Party 8:30 a.m.

 

                                                         Mail-In Registration Form

                        Please fill-out, print and sign the form. Please fill out one form for each entry.
                            Make check payable to: The Islands Community Association


Mail to: Arizona RunningEvents Co. (ARC) ~ 5290 W. Melinda Ln. ~ Glendale, AZ 85308
 

Please note: a signed registration form is REQUIRED for EACH participant.

 

Last Name:    First Name:

Address:     Apt./Suite: 

City:             State:     Zip:

Phone:            Date of Birth:

Age on Race Day: Email Address:  

Gender: male    female

 

Event:  5K Run/Walk     1 Mile   ~   Adult T-Shirt Size: S  M  L  XL   XXL

                                                                  Youth Size  S   M   L

 

PRICING

Category

Early Entry
 (postmarked by 3/17/10)

Entry
 postmarked after3/17/10)

 Race-Day Entry

Fill in Amount

5K Walk/Run Entry Fee
(includes Pancake Breakfast)

 $22.00 $27.00 $27.00

1 Mile Family Fun Run/Walk Fee
(includes Pancake Breakfast)		 $7.00 $10.00 $10.00  
Extra Pancake Breakfast Tickets $3.00 each  ~  Number of tickets
 

TOTAL

  

       Check #  

 

 

Please read the waiver and sign the form. Thank You.
RELEASE FORM (MANDATORY): All applications MUST be signed to enter this event. No entry accepted without fee. NO REFUNDS.
 

In consideration of your acceptance of this entry, I, the undersigned, hereby, for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I may have against the sponsors, coordinating groups, and any individuals associated with the event, and their representatives, successors, officers, agents, and assigns, for any and all injuries sustained and suffered by me during this race. I verify that I am physically fit and have sufficiently trained for competition of this event and my physical condition has been verified by a licensed medical doctor. I will permit the free use of my name and hereby grant full permission to use any photographs, videotapes, motion pictures, recordings or any other record of this event for any legitimate purpose. I understand that the entry fee is non-refundable and numbers are not transferable. I have read the foregoing and certify my agreement by my signature below.

 

Signature:____________________________________________________________Date:________________
 

Parents signature (if under 18 years of age) & DATE)__________________________________________