Mail In Registration Form-drawchange5k 2016

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Drawchange is a 501(c)(3) organization whose mission is to aid global change by supplying the world’s children with empowering art experiences. Together we can provide the programs that allow them to effectively visualize a better life for themselves. Please make checks payable to drawchange Inc. Must be postmarked by Sep 15, 2016 VISIT WWW.DRAWCHANGE.ORG/5K TO LEARN MORE FIRST NAME LAST AGE GENDER M F T-SHIRT SIZE S M L XL 2XL (FREE W/REG) ADDRESS CITY STATE ZIP EMAIL REGISTRATION FEE $ Yes, I want to add an additional donation of: $ TOTAL PAID $ Run for Art, Run for Kids, a drawchange 5k SCAN TO REGISTER A Creatively Charged 5k run/walk with entertainment along the route! * drawchange.org/5k * facebook.com/drawchange5k * * instagram.com/drawchange5k * Send with payment to: drawchange 5k | PO BOX 7201, ATLANTA, GA 30357 Note: Separate entry form and signed waiver must be completed for each registrant. WAIVER: I know that running and participating in training run programs are potentially hazardous activities. I should not run unless I am medically able, with consent from my physician, to properly prepare and participate in the Run For Art, Run For Kids 5k (hereinafter called “Road Race”). I assume all risk associated with running and preparing for the “Road Race”, including but not limited to falls, contact with other participants, weather, including high heat and/or humidity, traffic, and road conditions. Having read this waiver, and in consideration of your accepting my entry to the “Road Race”, I, for myself and anyone entitled to act on my behalf, waive and release drawchange Inc, all city, county, and state governments, and all sponsors, their representatives and successors, from all claims or liabilities of any kind arising out of my participation in this road race/training program. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. I understand that all entries are final with no refunds. The official race director reserves the right in any event of emergency or local or national disaster to cancel the race or to change the day/time to a later day and that in the event of cancellation or change there is no refund of entry fees. I agree to the above waivers and disclaimers. I agree to the above waivers and disclaimers. Participant Parent of Participant under the age of 18 Fee Schedule : MAY 1 - MAY 15 $20.00 MAY 16 - JUL 31 $25.00 AUG 1 - AUG 31 $30.00 SEP 1 - SEP 30 $35.00 * AWARDS ARE CREATED BY THE CHILDREN YOU ARE SUPPORTING! Top Overall & Master Male/Female Top Three Overall Male/Female Age Groups Rewarded in 6 Age Groups Live music & artistic entertainment along the route! drawchange TM OR VISIT ONLINE: drawchange.org/5k SATURDAY, OCT 1st, 8AM RUN FOR ART, RUN FOR KIDS! PIEDMONT PARK, ATLANTA

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If you choose to register via U.S. Mail, please fill out the form and mail it to PO BOX 7201, Atlanta, GA 30327 or email to [email protected] with your payment. Run for Art, Run for Kids, 3rd annual #drawchange5k!

Transcript of Mail In Registration Form-drawchange5k 2016

Page 1: Mail In Registration Form-drawchange5k 2016

Drawchange is a 501(c)(3) organization whose mission is to aid global change by supplying the world’s children with empowering art experiences. Together we can provide the programs that allow them to e�ectively visualize a better life for themselves.

Please make checks payable to drawchange Inc.Must be postmarked by Sep 15, 2016

VISIT WWW.DRAWCHANGE.ORG/5K TO LEARN MORE

FIRST NAME LAST

AGE GENDER M F T-SHIRT SIZE S M L XL 2XL (FREE W/REG)

ADDRESS

CITY STATE ZIP

EMAIL

REGISTRATION FEE $ Yes, I want to add an additional donation of: $

TOTAL PAID $

Run for Art, Run for Kids, a drawchange 5k

SCAN TO REGISTER

A Creatively Charged 5k run/walk

with entertainment along the route!

* drawchange.org/5k * facebook.com/drawchange5k * * instagram.com/drawchange5k *

Send with payment to: drawchange 5k | PO BOX 7201, ATLANTA, GA 30357

Note: Separate entry form and signed waiver must be completed for each registrant. WAIVER: I know that running and participating in training run programs are potentially hazardous activities. I should not run unless I am medically able, with consent from my physician, to properly prepare and participate in the Run For Art, Run For Kids 5k (hereinafter called “Road Race”). I assume all risk associated with running and preparing for the “Road Race”, including but not limited to falls, contact with other participants, weather, including high heat and/or humidity, tra�c, and road conditions. Having read this waiver, and in consideration of your accepting my entry to the “Road Race”, I, for myself and anyone entitled to act on my behalf, waive and release drawchange Inc, all city, county, and state governments, and all sponsors, their representatives and successors, from all claims or liabilities of any kind arising out of my participation in this road race/training program. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. I understand that all entries are �nal with no refunds. The o�cial race director reserves the right in any event of emergency or local or national disaster to cancel the race or to change the day/time to a later day and that in the event of cancellation or change there is no refund of entry fees. I agree to the above waivers and disclaimers.I agree to the above waivers and disclaimers. Participant

Parent of Participant under the age of 18

Fee Schedule : MAY 1 - MAY 15

$20.00MAY 16 - JUL 31

$25.00AUG 1 - AUG 31

$30.00SEP 1 - SEP 30

$35.00

*

AWARDS ARE CREATED BY THE CHILDREN YOU ARE SUPPORTING!

Top Overall & Master Male/FemaleTop Three Overall Male/Female Age Groups Rewarded in 6 Age Groups

Live music & artisticentertainment along the route!

drawchange

TM

OR VISIT ONLINE:drawchange.org/5k

SATURDAY, OCT 1st, 8AM

RUN FOR ART, RUN FOR KIDS!

PIEDMONT PARK, ATLANTA

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