Official Entry Form

Early by Mail Registration will take place from now up to April 30th...your entry must be received by April 30th.

Name:______________________________________________

Address:____________________________________________

City:________________________________________________

State:____________________ Zip Code:___________________

Phone Number:(___)_____-_____________

Email Adress:_________________________________________

T-shirt Size:  sm, med, lg, xl =_________

Date of Birth:_______________ Age on Race Day:___________

Gender:(circle one) male or female

Early entry $15.00 if received by APRIL 30th......total=___________

Late entry including race day registration is $20.00....total=_________

Old Fart Running Club Discount(-$5.00)...club #_______

Guys "Wear a Grandma Mask" -$3.00 discount=_______

Method of Payment: check #=______________

                                      money order=___________

                                      cash=_________________

Print Off and Mail this entire page with check or money order payable to:

Old Farts Running Club

 2010 Woodrun

Lowell, Michigan, 49331

BEAT the Grandma 5K Race Waiver Form

WAIVER MUST BE SIGNED IN ORDER TO BE ACCEPTED INTO THE BEAT THE GRANDMA ROAD RACE. IN REGISTERING FOR THIS RACE I STATE THAT I AM FULLY AWARE, UNDERSTAND, AND ASSUME ALL THE RISKS AND RESPONSIBILITY FOR PARTICIPATING IN THIS RACE ON A COURSE WITH VEHICULAR TRAFFIC AND THAT I AM FULLY CONDITIONED FOR THIS RACE TO THE LEVEL OF APPROPRIATE FITNESS. I ALSO WAIVE ALL CLAIMS AGAINST THE RACE DIRECTORS, HOST SITE, SPONSORS, THE CITY OF GRAND RAPIDS, ETC. AND I AM ALSO AWARE OF THE FACT THAT IF THE RACE GETS CANCELLED DUE TO WEATHER OR OTHER REASONS THAT THE RACE ENTRY IS NON-REFUNDABLE.

SIGNATURE:____________________________________DATE:__________________________

PARENT or GUARDIAN MUST SIGN IF UNDER 18 YEARS OF AGE:

SIGN:_________________________________________DATE:___________________________