• Mail-In Entries must be received by Wednesday, May 7th

Mail to:
AA Sports
4840 SW Western Ave.
Suite 400
Beaverton, OR 97005

Event (Choose One) (all entries include short-sleeved T-shirt):

- 5K Run/Walk - $25 (received on or before 5/9), $30 (Packet Pickup & DOR) 12K Run - $30 (received on or before 5/9), $35 (Packet Pickup & DOR) Kid's (ages 12 & under) - $15.00

First Name / MI / Last Name

ChampionChip Number (if applicable - Example - CE12345)

Street Address

City

State/Province

Zip/Postal Code

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

Age

Gender
- Female Male
Phone

Email

Division (5k&12k)
- 14 years & under 15 - 19 years 20 - 24 years 25 - 29 years 30 - 34 years 35 - 39 years 40 - 44 years 45 - 49 years 50 - 54 years 55 - 59 years 60 - 64 years 65 - 69 years 70 years & over Clydesdale (males 198 lbs & over) Athena (females 150 lbs and over)
T-Shirt (included with entry Fee)
- S - Kid's Race M - Kid's Race L - Kid's Race S - Adult M - Adult L - Adult XL - Adult XXL - Adult (Add $3.00 to entry fee)
Check#


Amount Enclosed


WAIVER MUST BE READ, SIGNED AND MAILED WITH ENTRY
OFFICIAL WAIVER: I know that running/walking a road race is a potentially hazardous activity. I should not enter and run/walk unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run/walk. I assume all risks associated with participating in this event including, but not limited to falls, contact with other participants, the effects of weather, including high humidity, traffic and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of acceptance of my entry, I for myself and anyone entitled to act on my behalf, waive and release Lake Oswego Junior Women's Club, City of Lake Oswego, Kruse Way Lake Oswego Rotary Club, AA Sports, Ltd., and any and all persons, sponsors and entities, their representatives and successors from all claims or liabilities of any kind arising out of my participation even though said liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission for all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. Parents must sign if participant is under 18 years of age. This is to certify that my child has permission to complete in this event, is in good physical condition and that event officials may authorize necessary emergency treatment. I understand that I must return the Timing Chip assigned to me or to pay a $30.00 replacement fee. 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________________________________________