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TO REGISTER
CLICK HERE or see the form details below.
ENTRY FORM
Please fill out one entry form per person. Families should send all forms together.
Last Name:________________________ First Name:______________________
Address:_________________________________________________________
City ___________________________ State____________ Zip_______________ Age as of June 19, 2011:_______
E-mail:_____________________________________________________________ Gender: M | F
T-Shirt Size (circle one): Adult S | Adult M | Adult L | Adult XL | Adult XXL | Youth S | Youth M | Youth L
Check Race(s): Kids’ Sprint ___ Half-Mile Fun Run ___ 5K ___
Please make checks payable to ICJSL, Mail to: PO Box 3084, Iowa City, IA 52244-3048 | Questions: icjslsolsticestride@gmail.com
In consideration of acceptance of entry, I for myself, my executors, administrators and assignees do hereby release and
discharge the directors, race committee, all sponsors and land owners for all claims of damages, demands, and actions whatsoever in any manner arising or growing from my participation in the 5K or Fun Run Solstice Stride.
Signature (If under 18, parent or guardian must also sign): _______________________________________________________________
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Office use only: Check#______________ Cash___________ Amt_____________ Age Group__________
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