5K Sargent County Fair Run/Walk

Saturday, July 28th

5 K Run 8:00 am

1 Mile Kid’s Fun Run 9:00 am

ENTRY FEE:

$20 ‐ 18 and under before July 8th

$25 – 19 and over before July 8th

After July 8th add $5.00

Proceeds will go to the Sargent Central Health and Wellness committee

NO roller blades or bicycles (Strollers okay!)

AWARDS: Top 3 overall Male and Female finisher and

Top 3 in each category: 0‐14 15‐25 26 – 49 50+ will receive medals

Every participant will receive a Sargent County Gate Pass for Saturday

T‐SHIRTS: Guaranteed to those who register by July 8th

REGISTRATION:

Mail in form below and check made payable to: Kristine Askerooth register the day of the race between 7:30 am and 8:00 am in Downtown Forman. Mail to: Kristine Askerooth; 14248 88th St SE; Cayuga, ND 58013

‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ cut here ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ cut here ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐

Name: _____________________________________

Address: ___________________________________ City/State/Zip Code ________________________

Age: ___________ Male/Female _________

T‐Shirt Size: Adult Small ____ Medium ____ Large ______ X‐Large______ XX Large _____

Child Small _____ Medium _____ Large ______

WAIVER: I, the undersigned, intending to be legally bound for myself, my heirs, executors, and administrators, do hereby release any and all sponsors of this race and their representatives, successors, and assigns, from any and all liability arising from illness or injuries I may suffer as a result of participation in this race. I also understand that entry fees I pay are not refundable. I have read the foregoing and certify my agreement by my signature below.

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Signature (Signature of Parent or Legal Guardian is under 18) Date