Mail to:
City of Great Falls, Parks & Rec
PO Box 5021
Great Falls, MT 59403

Event - Choose One (T-shirt included in entry):

- 5-Mile - $18.00 Run ($12.00 for kid's 10 years & under) - Add $2.00 Race Day 3-Mile - $18.00 Run ($12.00 for kid's 10 years & under) - Add $2.00 Race Day 1-Mile - $18.00 ($12.00 for kid's 10 year & under) - Add $2.00 Race Day

SPECIAL FAMILY RATE (please fill out an entry for each person indicating which event they are participating in - then submit the entries with the special fee.)
- Yes ($50 (2 adults, 2 kids), and $10 for each add'l entry)
First Name / MI / Last Name

Street Address

City

State/Province

Zip/Postal Code

Birthdate - mm/dd/yy (birth year not 2008)

Age

Gender
- Female Male
Phone

Email

Division (Individuals)
- 6 to 9 Years 10 to 12 Years 13 to 15 Years 16 to 18 Years 19 to 24 Years 25 to 29 Years 30 to 34 Years 35 to 39 Years 40 to 44 Years 45 to 49 Years 50 to 54 Years 55 to 59 Years 60 to 64 Years 65 to 69 Years 70 Years & Over
T-Shirt Size
- Youth M S M L XL
Check#

Amount Enclosed

WAIVER MUST BE READ, SIGNED AND MAILED WITH ENTRY
OFFICIAL WAIVER: I know that participating in an organized athletic event is potentially hazardous, and that I should not enter to participate unless I am medically able and properly trained. I HEREBY ASSUME THE RISKS OF PARTICIPATING IN THIS EVENT. I certify that I am physically fit and that I have sufficiently trained. I agree to abide by the competitive rules. I hereby take the following action for myself, my executors, administrators, heirs, next to kin, successors and assigns, or anyone else who might claim or sue on my behalf, and I hereby waive, release and discharge from any and all claims, losses, or liabilities for death, personal injury, partial or permanent disability, property damage, medical or hospital bills, or theft which may arise out of or relate to my participation in this event. I agree not to sue, and to hold harmless any and all persons, sponsors, volunteers, participants or government agencies for any and all claims or liabilities that I have waived, released or discharges herein. I also agree to return the ChampionChip timing devise assigned to me or to pay a $30 replacement fee. I understand that the Entry Fees are Non-Refundable/Non-Transferable.

Type Full Name


Signature X ___________________________________________________________________
(Signature of Parent or Legal Guardian if participant is under the age of 18)

Date________________________________________