Saturday, May 13th at 8:30 am
Start/Finish: 119 Charles Street
Oconto, WI
5K Run/Walk or 10K Run • Chip Timed
Music • Post-Race Refreshments
Adults - $25 • Kids (12 & Under) - $15
**Only paid participants will receive a swag bag, shirt,
finishing medal and GB Blizzard Ticket **
All proceeds go to the Ronald McDonald House & MACC Fund Center
2017 Team Registration Form
Please provide information for each team member on
separate team members form.
Team Name:
Team Leader’s Name:
Phone Number:
Email Address:
Team Leader Signature:
Date:
MINIMUM 5 MEMBERS PER TEAM—NO MAXIMUM
Adult Shirt Size Options (If available): Small Medium Large X‐Large XX‐Large
Youth Shirt Size Options (If available): Small Medium Large
Please return both forms with payment and checks payable to:
Miles 4 Madyson, Inc.
1441 Kord Ct.
Oconto, WI 54153.
www.Miles4Madyson.com
ALL PARTICIPANTS MUST COMPLETE AND SIGN THIS FORM
Name
Phone number or
E-mail
Shirt Size
(Specify
Youth or
Adult)
5K/10K
(Circle)
Gender
M/F
(Circle)
5K / 10K
M/F
Y/N
$
5K / 10K
M/F
Y/N
$
5K / 10K
M/F
Y/N
$
5K / 10K
M/F
Y/N
$
5K / 10K
M/F
Y/N
$
5K / 10K
M/F
Y/N
$
5K / 10K
M/F
Y/N
$
5K / 10K
M/F
Y/N
$
5K / 10K
M/F
Y/N
$
5K / 10K
M/F
Y/N
$
5K / 10K
M/F
Y/N
$
5K / 10K
M/F
Y/N
$
5K / 10K
M/F
Y/N
$
5K / 10K
M/F
Y/N
$
5K / 10K
M/F
Y/N
$
Date of
Birth
Under
13?
Participant Signature acknowledging
disclaimer below (parent signature is
required if participant is under 18)
Reg. Fee
Paid
TOTAL: $
ACKNOWLEDGMENT, WAIVER and RELEASE FROM LIABILITY
I know that running or volunteering for a run is a potentially hazardous activity, which could cause injury or death. I will not enter or participate unless I am medically able and properly trained. By
entering my name below, I certify that I am medically able and properly trained to perform in this event. I agree to abide by any decision of a race director to deny or suspend my participation for any
reason whatsoever. I attest that I have read the rules of the race and agree to abide by them. I assume all risks associate with running in this event, including but not limited to falls, contact with other
participants, the effects of the weather, including ice, snow, high heat and/or humidity, traffic, the conditions of the road, all such risks being known and appreciate by me. I understand that
skateboards and roller skates are not allowed in the race and I will abide by all race rules.