1
PINK RIBBON 7k Run /Walk Oct. 26, 2013 WAIVER I hereby release the U of A, Vail Academy & High School, Vail School District, Tagg Running Events, USATF and all munici- pal agencies whose property and/or personnel are used and other sponsoring or co-sponsoring company (ies), agency (ies), or individual(s) from responsibility or any injuries or damages I may suffer as a result of my participation in the Pink Ribbon and all other events. I hereby certify that I am in good condition and am able to safely compete in this event. I will additionally permit the use of my name and pictures in broadcasts, telecasts, newspapers, brochures, etc. and I also understand that the entry fee is non- refundable. As a participating athlete I certify that all information provided in this form is true and complete. I have read the entry information provided for the event and certify my compliance by signature below. Bib numbers are non-transferable. IF ATHLETE IS UNDER AGE 18: This is to certify that my child has my permission to run in the Pink Ribbon, is in good physical condi- tion, and that race officials have my permission to authorize emergency treatment if necessary. PARTICIPANT’S SIGNATURE (or parent/guardian if participant is under 18 years) Date Make check payable to: Tagg Running Events PLEASE COMPLETE ALL INFORMATION ONE FORM PER PARTICIPANT FIRST NAME LAST NAME M F BIRTHDATE (MM/DD/YY) AGE ON RACE DAY AREA CODE PHONE E-MAIL ADDRESS: TEAM/CLUB NAME: STREET ADDRESS APT. NUMBER CITY STATE ZIP ( ) Official use only Location: Vail Academy and High School 7762 E. Science Park Dr. Tucson, AZ 85747 *MUST ENTER FROM KOLB ROAD Course: Starts and finishes at Vail Acad. and High School and runs along Science Park Dr. at the UA Tech Park with views of the Solar Zone. Registration & Bib Number Pickup: 7:00 - 7:55 a.m. Start Time: 8:00 a.m. Features: • FREE T-shirt if pre-registered by 10/17/13 Awards to top 3 finishers in divisions • Award to First Breast Cancer Survivor Finisher • On-line registration provided by Race Director: Steve Taggart - (520) 820-6447 [email protected] www.taggrun.com COMPLETE FRONT & BACK OF ENTRY FORM T-Shirt: (circle one) Adult sizes: S M L XL XXL (add $4) Youth sizes: S M L FREE T-shirt guaranteed if entry received by 10/17/13 Are you a breast cancer survivor? Y N Please mail completed entry form and fee to: Tagg Running Events P.0. Box 1029, Vail, AZ 85641 FEES: (circle price) 18 and older Until 9/1/13 $25 17 and Under Until 9/1/13 $20 All participants 9/2/13 until race day $30 Long sleeve tee upgrade $15 (received by 10/17/13) Hooded Sweatshirt $30 Donation $______ Total $______ A portion of proceeds will benefit For more information Fliers provided by ENTRY FORM Music provided by COMPLETE FRONT & BACK OF ENTRY FORM Saturday, October 26, 2013 4th Annual

PINK RIBBON - Tagg Run

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Page 1: PINK RIBBON - Tagg Run

PINK RIBBON 7k Run/Walk

Oct. 26, 2013

WA

IVER

I he

reby

rele

ase

the

U o

f A, V

ail A

cade

my

& H

igh

Scho

ol, V

ail S

choo

l Dis

tric

t, Ta

gg R

unni

ng E

vent

s, U

SATF

and

all

mun

ici-

pal a

genc

ies

who

se p

rope

rty

and/

or p

erso

nnel

are

use

d an

d ot

her

spon

sorin

g or

co-

spon

sorin

g co

mpa

ny (

ies)

, age

ncy

(ies)

, or

indi

vidu

al(s

) fro

m r

espo

nsib

ility

or

any

inju

ries

or d

amag

es I

may

suf

fer

as a

res

ult

of m

y pa

rtic

ipat

ion

in t

he P

ink

Ribb

on a

nd a

ll ot

her e

vent

s.  I

here

by c

ertif

y th

at I

am in

goo

d co

nditi

on a

nd a

m a

ble

to s

afel

y co

mpe

te in

this

eve

nt. I

will

add

ition

ally

per

mit

the

use

of m

y na

me

and

pict

ures

in b

road

cast

s, te

leca

sts,

new

spap

ers,

broc

hure

s, et

c. a

nd I

also

und

erst

and

that

the

entr

y fe

e is

non

-re

fund

able

. As

a pa

rtic

ipat

ing

athl

ete

I cer

tify

that

all

info

rmat

ion

prov

ided

in th

is fo

rm is

true

and

com

plet

e. I

have

read

the

entr

y in

form

atio

n pr

ovid

ed fo

r the

eve

nt a

nd c

ertif

y m

y co

mpl

ianc

e by

sig

natu

re b

elow

. Bib

num

bers

are

non

-tra

nsfe

rabl

e.IF

ATH

LETE

IS U

ND

ER A

GE

18: T

his i

s to

cert

ify th

at m

y ch

ild h

as m

y pe

rmis

sion

to ru

n in

the

Pink

Rib

bon,

is in

goo

d ph

ysic

al c

ondi

-tio

n, a

nd th

at ra

ce o

ffici

als

have

my

perm

issi

on to

aut

horiz

e em

erge

ncy

trea

tmen

t if n

eces

sary

.

PART

ICIPA

NT’

S S

IGN

ATUR

E (o

r par

ent/g

uard

ian

if pa

rticip

ant i

s und

er 1

8 ye

ars)

D

ate

Mak

e ch

eck

paya

ble

to:

Tagg

Run

ning

Eve

nts

PLEA

SE C

OM

PLET

E AL

L IN

FORM

ATIO

N

• O

NE

FORM

PER

PA

RTIC

IPA

NT

FIRS

T N

AME

LAST

NAM

E

M

F

BIR

THD

ATE

(M

M/D

D/Y

Y)

A

GE

ON

RAC

E D

AY

ARE

A CO

DE

PH

ON

E

E-

MAI

L AD

DRE

SS:

TEAM

/CLU

B N

AME:

STRE

ET A

DD

RESS

APT

. NU

MBE

R

CITY

STA

TE

ZIP

(

)

Offi

cial

use

onl

y

Location: Vail Academy and High School 7762 E. Science Park Dr. Tucson, AZ 85747 *MUST ENTER FROM KOLB ROAD

Course: Starts and finishes at Vail Acad. and High School and runs along Science Park Dr. at the UA Tech Park with views of the Solar Zone.

Registration & Bib Number Pickup: 7:00 - 7:55 a.m.

Start Time: 8:00 a.m.

Features: • FREE T-shirt if pre-registered by 10/17/13 • Awards to top 3 finishers in divisions • Award to First Breast Cancer Survivor Finisher • On-line registration provided by

Race Director: Steve Taggart - (520) 820-6447 [email protected] www.taggrun.com

COM

PLET

E FR

ON

T &

BA

CK O

F EN

TRY

FORM

T-Shirt: (circle one)

Adult sizes: S M L XL XXL (add $4)

Youth sizes:S M L

FREE T-shirt

guaranteed if entry received by 10/17/13

Are you a breast cancer survivor? Y N

Please mail completed entry form and fee to:Tagg Running Events

P.0. Box 1029, Vail, AZ 85641

FEES: (circle price)

18 and older Until 9/1/13 $25

17 and Under Until 9/1/13 $20

All participants 9/2/13 until race day $30

Long sleeve tee upgrade $15 (received by 10/17/13)

Hooded Sweatshirt $30 Donation $______

Total $______

A portion of proceeds will benefit

For more information

Fliers provided by

ENTRY FORM

Music provided by

COMPLETE FRONT & BACK OF ENTRY FORM

Saturday, October 26, 2013

4th Annual