17th Annual Phoenix 5K Fundraiser
Complete the entry form below to register for the 17th annual Phoenix 5K. All proceeds will benefit the Green Bay men's and women's cross country programs. Date: April 19, 2014 Location: Kress Events Center UW-Green Bay Campus 2420 Nicolet Drive Green Bay, WI 54311 Time: 5K starts at 10:15 a.m. (immediately following Kiddie Run at 10 a.m.) Entry Fees: - $20 pre-registered runners ($25 on race day) - $15 pre-registered UW-Green Bay students and staff ($20 on race day) - $7 pre-registered Kiddie Run ($10 on race day) *Pre-register by April 14, 2014 Send entry fee to: Michael Kline Kress Events Center 2420 Nicolet Drive Green Bay, WI 54311 (Make checks payable to UW-Green Bay Cross Country) For more information, contact Mike Kline at 920-465-2950 or klinem@uwgb.edu

Required Fields in Bold

Name
 
Address
 
Phone Number
 
Email Address
 
Sex
 
Male
Female
Birthdate (Month, Day, Year)
 
Age on Race Day
 
Race
 
Phoenix 5K ($20 or $15 for UW-Green Bay students/staff)
Kiddie Run ($7)
T-Shirt Size
 
XL
L
M
S
Signature (your name if over 18, parent/guardian name if under 18)
 
In consideration of your accepting this entry, I, the above signed, intending to be legally bound, hereby, for myself, my heirs, executors and administrators waive and release any and all rights and claims for damages I may have against UW-Green Bay, the State of Wisconsin, the City of Green Bay, any organizers or workers. all sponsors and their representatives, successors and assigns for any and all injuries suffered by me in said event. I attest and verify that I will participate in this event as a footrace entrant, that I am physically fit and have sufficiently trained for the completion of this event and my physical condition has been verified by a licensed Medical Doctor. Further, I hereby grant full permission to any and all foregoing to use any photographs, video tapes, motion pictures, recording, or any other record of this event. NO REFUNDS, EXCHANGES, OR TRANFERS.
 
Agree
 
First time entry?
 
Yes
No
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