PLEASE MAIL FORM BEFORE FRIDAY APRIL 25TH

Instructions: Type in your information in the blanks provided. (that's right, you can actually type it in!!!)
Print entry form & SIGN WAIVER (Entry will not be accepted without the signed waiver)
Make Checks Payable to:
Terrapin Events and mail to: PO Box 15257 Portland OR 97293

ENTRY (Choose One) REGISTRATION MUST BE RECEIVED BEFORE APRIL 20TH TO PURCHASE A TECH SHIRT

5K RUN / WALK (WITHOUT SHIRT)
      $20 BEFORE SAT PACKET PICKUP
      $30 PACKET PICKUP AND DAY OF RACE
5K RUN / WALK (WITH COTTON SHIRT)
      $27 BEFORE SAT PACKET PICKUP
      $35 PACKET PICKUP AND DAY OF RACE
$35 5K RUN / WALK (WITH TECH SHIRT)
      ONLY AVAILABLE BEFORE APRIL 20TH
10K RUN / WALK (WITHOUT SHIRT)
      $20 BEFORE SAT PACKET PICKUP
      $30 PACKET PICKUP AND DAY OF RACE
10K RUN / WALK (WITH COTTON SHIRT)
      $27 BEFORE SAT PACKET PICKUP
      $35 PACKET PICKUP AND DAY OF RACE
$35 10K RUN / WALK (WITH TECH SHIRT)
      ONLY AVAILABLE BEFORE APRIL 20TH
1/2 MILE KIDS DASH (WITH SHIRT)
      $10 (WITH COTTON T)
   

PARTICIPANT INFO:
First Name / MI / Last Name

Street Address                                                                                               City
  
State/Province                                                    Zip/Postal Code

Phone

Birthdate - mm/dd/yy                 Gender

Email (non-business)

T-Shirts Size (add 2.00 for XXL)


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 Terrapin Events, City of Portland, State of Oregon (ODOT), 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. ENTRY FEES ARE NON-REFUNDABLE.

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