Pullman Parks & Recreation: Pioneer Center, 240 SE Dexter: 509-338-3227
Register online at: PullmanParksandRec.com
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FUN ACTIVITIES
RACE TIME: 9:30am start for both courses
5K & 10K: Start at the Bill Chipman Palouse Trail Trailhead
REGISTRATION: Accepted online at PullmanParksandRec.com or Active.com, by mail, or in person at Pullman
Parks & Recreation offi ce. Pre-registration packets will be available on Thurs-Fri, Oct 25-26 at the Pioneer Center,
between 8:00am and 5:00pm.
DEADLINE: Register by Oct 12 to guarantee a shirt on race day. Late registrations will be accepted by mail or until
45 minutes prior to race time at the Bill Chipman Palouse Trail Trailhead.
Pullman Parks & Recreation - 2018 Care-to-Share Fun Run Entry Form
Name _________________________________________________________________Phone_________________________
Address_________________________________________________City____________State________Zip________________
Email___________________________________________________Age on Race Day___________ Male Female
Race Distance: 5K 10K
Register Fee: with shirt $25 without shirt: $15
(Must register by Oct. 12 to guarantee a shirt on race day)
Shirt Size: Child: M L
Adult: S M L XL XXL
LIABILITY AND MEDICAL RELEASE AGREEMENT: I, the undersigned adult, on behalf of myself and my child(ren) assume all risks and hazards
reasonably related to the conduct of the program, and/or rental or use of any City of Pullman facility. Further, I do hereby release and hold harmless the
City of Pullman, its elected and appointed offi cials and employees, organizer, sponsor, supervisor, contracted facilitator, or any volunteer connected with
a program, facility rental and/or use, from any and all claims, injuries, damages, losses and suits, including attorney fees, arising out of or in connection
with the program or rental and/or use of a City of Pullman facility. I acknowledge that I have familiarized myself with the description of the activity(ies),
rental or use of a facility, and understanding the hazards, myself and my child(ren)'s personal limitations, and knowingly assume all risks. In the event
of a medical emergency, I authorize transportation to the nearest appropriate medical facility, and authorize emergency medical care if no one listed on
the MIF (Medical Information Form) can be reached. If applicable, I authorize City of Pullman program facilitators, to administer medication to my child
as outlined on the MIF form, and release from all liability said facilitators for any injury resulting from the administration of those medications, provided
all medications are administered in accordance with the schedule and conditions. In the absence of a signature, payment of fee and participation
in the program or use of a facility shall constitute acceptance of the conditions set forth in this release. PHOTO: I grant full permission to use any
photographs, videotapes, motion pictures, recordings or any other record of this program for any City of Pullman informational or promotional use.
Signature (Participant or Parent/Guardian) X________________________________________________Date_____________
Pullman Parks & Recreation
10
th
Annual
Care-to-Share Fun Run
Sat, Oct 27th - 9:30am
Bill Chipman Palouse Trail Trailhead
Running, Jogging, Walking, Talking
...Make it a Family Aff air! ...Make it a Family Aff air!
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