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Welcome to the
Stillwater Youth Center


Run the race 2014 • Registration



Registration Form

IF YOU DO NOT WISH TO PAY ON-LINE CLICK HERE
TO DOWNLOAD THE REGISTRATION FORM AND MAIL IT
WITH YOUR PAYMENT TO STILLWATER YOUTH CENTER.
PAYMENT MUST BE RECEIVED BY JULY 15TH
TO QUALIFY FOR EARLYBIRD PRICING

All checks should be made out to Stillwater Youth Center and mailed to:

SYC, P.O. Box 1148, Columbus, MT 59019.


Call (406)322-5440 if you have any questions.

TO REGISTER ON-LINE AND PAY ON-LINE

FILL OUT THE FORM BELOW AND SUBMIT.


SATURDAY, AUGUST 23rd, 2014 5K Run/Walk START TIME IS 8:00AM, REGISTRATION
7:15-7:45 at Columbus High School Track on 4th Avenue

ONE FORM PER PERSON
* Last Name:
* First Name:
* Mailing Address:
* City:
* State:
* Zip:
* Day Phone:
* Age as of Aug 18, 2014:

Male:

 Female:
* Your email address:

5K:

 5K Walk  1 Mile:  100 Yd Dash:  Family Medley Relay Race:

Strollers are welcome in the races but please, no dogs, horses, or bicycles. You may run and walk if entered in the 5K run, but please, no running if you are registered in the 5K walk.

1 Mile Race, 100 yard Dash, and Family Medley Relay Race will take place after the 5K Run/Walk. Family Medley Relay Race is a race that involves all immediate family members. Each family entered will be running the same distance. Each member of the family will have a set distance to run (distances will be determined according to age and capability). An article (such as a baton) will be passed from the running member to the next member in line to run. The first family to finish the race will be the winning team.Challenges: Church Challenge, Business/Team Challenge, Family Challenge, Challenge Rules: All Challenges are open to adults and youth. You may be part of more than one Challenge. You must be registered as part of a Challenge. If part of more than one Challenge you must be registered for each individual Challenge. If you are not registered as part of a Challenge you will not be counted as part of the Challenge come race day. The winning Challenge category teams will be based on how many participants are registered not based on race times. Business/Team challenge is for either a business or a group of individuals that would like to put a team together.

Church Challenge

Yes:  No:  Church Name:

Business/Team Challenge

Yes:  No:                Name:

Family Challenge

Yes:  No:    Family Name:

Family Rate covers all registered races for that family.

If you are not registered for Family Rate you do not receive family rate.


Registration Fee - Per Person

 Early Bird $25 by July 15th: $  $30 July 15th-July 31st: $
                             $35 after August 1st: $


Family Rate

 Early Bird $100 by July 15th: $  $125 July 15th-July 31st: $
                             $150 after August 1st: $


Register by July 31st to receive a t-shirt

 Adult Small Adult Medium Adult Large Adult X-Large


           Youth Small Youth Medium Youth Large

ALL RACE PARTICIPANTS MUST READ AND SIGN/FILL IN:


In consideration of the acceptance of this entry form and for being permitted to voluntarily participate in this event, I hereby assume full and complete responsibility for any injury or accident which may occur during my participation in this event, and I hereby release and hold harmless the sponsors and organizers of the Stillwater Youth Center "Run the Race" 2014 and their agents and employees, and all other persons or entities associated with this event from any loss, liability, damage, or claims I may have arising out of my participation in this event, including personal injury or damage suffered by me or others whether same be caused by falls, contact with other participants, conditions of the course, negligence of the parties involved or otherwise. I also hereby consent to permit, and accept full responsibility for emergency treatment in the event of injury or illness. I give my full permission to the parties involved to use my photograph, video, or other recordings of me that are made during the course of this event for any purpose.

Voluntary Participant:
If under 18 - Parent or Guardian:
Date:

Thank you for supporting the Stillwater Youth Center.

All proceeds from race registration will go towards ministering to the youth of the
Stillwater Valley at SYC. See www.stillwateryouthcenter.com for more information.
Enter the Code that Appears on the right side
of the yellow box and then click on Submit.


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