April 26, 2015 Wild Horse Wind and Solar Facility www.Run-Like-The-Wind.com info@runforgoodracingcompany.com To register please fill out this form and return with payment to: Run for Good Racing Company 204 7th Ave N Edmonds, WA 98020 Name:_______________________________________________________________________________________ Address:_____________________________________________________________________________________ City, State, Zip:_______________________________________________________________________________ Phone number: ______________________________________________________________________________ Email: _______________________________________________________________________________________ Race: (please circle one) 5K 10K Date of Birth:___________________ Half Marathon 30K Male Female(please circle one) Emergency Contact name and phone number: _______________________________________________ Payment Information: Please circle one: $30 5K $40 10K $50 Half Marathon $65 30K Shirt size: small medium large extra large Would you like a free tour? Please circle which tour you would like: Before my race After my race Payment type (please circle one) Cash Check (please make checks out to ‘Run for Good’) I hereby certify that I am adequately fit to run in this race. In consideration of the acceptance of this entry, I, the undersigned, for myself, my personal representative, beneficiaries, and heirs, knowingly waive, release, and discharge any and all rights and claims which I have or may have hereafter accrue to me or my estate against the Race Organizers, Puget Sound Energy, Wild Horse Wind and Solar Facility, the City of Ellensburg and/or any other sponsors, organizers and volunteers and assigns for any and all injuries or death suffered by me in this event. I will also allow my picture and name to be used in publications as a result of this race. Signature:_______________________________________ Date: ______________________ (A parent or legal guardian must sign for participants under age of 18)
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