Team Registration

Porterville Breakfast Rotary Club
Cancer 5K Run/Walk

Saturday, May 2, 2009
Granite Hills High School - Event starts at 8:00 A.M. Sharp!

Online Registration Closed
   
  

Team prices are $100 by 4/24/09

Rules: Each team must consist of 5 registered members: Members must start and finish the race (short walk), Members must be connected during the entire race, Allow at least 4 ft. between each person. Teams will start at the rear of the race, costumes are encouraged (i.e. caterpillar, train, chain gang, etc), Teams must assemble no later than 7:45 for group pictures. Picture placecards will be awarded to: First to Finish, Best Costume, and Most Money Earned.

Check in 7:30 A.M. Pictures: 7:45 A.M. No team registrations the day of event Entry deadline is April 24, 2009

 

Team Registration Below.  For Individual Registration Click Here
    

Please Enter Team Information and click below to proceed to a secure credit card processing page. To register more than one Team select the "Add Additional Registration" option after submitting each registration or just click on the "Back Button" in Your Browser to return to this page.

Please notify garysmith@runwalkjog.com if you experience problems with online registration.  An online processing fee of $6.00 will be added to the registration fee for each team.

 
    
Porterville Cancer 5k Run Team Registration
  
                       Team Name:


Team Member 1 And Age: Example; Gary Smith 41
              T Shirt Member 1:  


Team Member 2 And Age:
              T Shirt Member 2:  


Team Member 3 And Age:
              T Shirt Member 3:  


Team Member 4 And Age:
              T Shirt Member 4:  


Team Member 5 And Age:
              T Shirt Member 5:  

 

Team Captain Information:


                   Captain Name:


                   Captain Phone:


                             Address:


                                    City:


                                  State:


                                     Zip:


                                 Email:

 

Please note: To participate in the race, each team member must provide a signed release agreeing to the terms of the following conditions. Print out and bring the signed waiver to pre-registration or to the event.  You  must have the form completed and turned in prior to event start.

Full Waiver and Release: In consideration for my entry being accepted, I hereby waive and release forever for myself and for my heirs, executors, administrators, any and all claims, causes of actions and suits I may accrue against the Porterville Breakfast Rotary Club, City of Porterville, County of Tulare, property owners on whose property the race is run, race director, volunteers and any sponsors of this race for any bodily injury, emotional injury, property damage or economic loss, including death suffered by me while traveling to and from or competing in the Porterville Cancer 5K Run and/or 5K or Short Walk, on May 2, 2009 whether from natural hazards, human-made hazards or any other defect or omission or act.

To Print Form Click Here (opens in new window)


 Waiver:    I understand that the release must be signed by each Team member and returned prior to participating in the event.  Print out and bring the signed waiver to pre-registration or to the event.  You  must have the form completed and turned in prior to event start.

 

Online Registration Closed
 

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