AT PO Box 486 Grosse Ile MI 48138 For questions feel free to email Greg at gregeveralracemgtcom Online registration wwwrunsignupcom F Female F Male XS S M L XL 5K Minion Mile In submitting this entry form I hereby waive any and ID: 76557
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Location : Meridian Elementary 26700 Meridian Grosse Ile, MI 48138 Time: 8 am – 10 am Registration 9:30 am Minion Mile 10 am Despicable Run 5K Entry Fee: $25 Pre - register by mail or online $30 October 25 - November 1 $35 November 2 Packet pick up Novemb er 2 Awar ds: Medal s for all finishers Aw ards for, M/F, overall and masters Mail To: Send completed forms with payment to P.A.T. P.O. Box 486 Grosse Ile, MI 48138 Contact Us: For questions, feel free to email Greg at greg@everalracemgt.com Online registration: www.runsignup.com - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Last Name ______________________ ____ ___ First Name ________ _______ _____________ Address __________________________ ___ ________ City ________ _________ _____________ State _______ Zip ______ ___ _____ Phone __________ ________ ________________________ Age on 11 - 2 - 14 _________________ Female Male Email Address __________________________________________________ ____________ ____ Shirt Size (Circle One) : XS S M L XL Race (Circle One): 5K Minion Mile PLEASE READ AND SIGN BELOW In submitting this entry form, I hereby waive any and all claims I may have against the Meridian Elementary , race organizers or sponsors for any injuries suffered by me in said event. I grant permission to use any video record of my participation in this event. I attest that I am physically fit and have sufficiently trained for this event . Signature _______________________________________ Date _________________ Parent / Guardian (under 18) _______________________ Date ________________ _ 5K Run/Walk & Minion Mile S unday November 2, 2014 A portion of proceeds go to support PAT Despicable Run