Waiver for Insurance Purposes
Note: This release form is a binding contract:
Read Carefully
(Must be signed by each race
registrant/parent or guardian)
In consideration of acceptance of this entry in the
Run to Read 5K Run/Walk, I hereby agree, for
myself, my heirs, executors and administrators, to
waive, release and discharge all rights and claims
which I may have against the sponsors of the
event, the organizer and promoter, the land own-
ers, and all contributors and any and all workers,
whether paid or voluntary, for any and all damagers which may be sustained by me or my family,
directly or indirectly in connection with my participa-
tion in or travel to or from the event. I agree to
personally inspect all race facilities and will refuse
to participate if I am not satisfied with the safety
thereof.
WI Stat 895.525 (3)(4) * “a participant in a recrea-
tional activity…accepts the risk inherent in the recre-
ational activity of which the ordinary prudent person
is or should be aware.”
(NO Individual times will be given)
Signature _______________________________
(must be signed by guardian if under 18
Date____________________
Mail this part of brochure to:
Marion Public Library
PO Box 267,
Marion, WI 54950
5K Run to Read will be a fun run with
obstacles along the 5K route that you
can take part in or just run by.
Bring the whole family
The Marion 5K “Sole2Soul” race is coming to an
end BUT a new and exciting race will be taking its
place. 5K Run to Read will start this year.
The Marion Public Library and Marion Elementary
School are teaming up to help expand and enhance
two outstanding projects, both held in the Marion
area.
The first project will allow the Marion Public
Library to give away free books to students as
prizes for reading and participating in library
activities. Over the years we have given away
free books on a limited basis, but we would like to
put more books in the hands of children
throughout the whole year.
The second project will be to enhance the Marion
Elementary Boat Mobile which is the summer
traveling book library. The purpose of our project
is to provide access and support to children so
they will want to continue reading over the
summer. We hope to help break the stranglehold
poverty has on our area by increasing children’s
love for reading and through encouraging lifelong
reading habits outside the classroom atmosphere.
Our centralized theme for summer has revolved
around fishing hence the name boat mobile. The
Boat Mobile stops at various locations including
rural areas three times a week during the summer.
The books are organized by reading levels, making
it easy for kids to find books they can read. Kids
can visit the Boat Mobile at any or all of the
locations and check and enhancement of the two
projects highlighted but will also help keep our
other programs running.
Marion, WI
Sat. August 3, 2013
Member FDIC
Registration
Advanced registration preferred. All advanced
registrations will be guaranteed a T-Shirt.
(Must register by 7-17-13 for T-Shirt.)
Friday, August 2
9:00 am - 3:00 pm
Race packet pick-up and late registration at
Marion Public Library
5K Run to Read will be a Fun
course will include optional
challenges throughout the run.
.
Name__________________________________
Address_____________________________
City/State/Zip______________________________
Phone_________________________________
Run/Walk with no individual timing.
In addition to running a 5K the
This form can be duplicated, (one per racer)
Saturday, August 3
Gender:
______Male
_____Female
Event
_______ 1 Mile
_______5K
8:30 am - Music and Fun
Race packet pick-up and late registration and
buy a duck if there are some left
“Field of Praise.” Check out all the activities going on
throughout the day with great music and food.
132 Parkview Ave, Marion)
9:15 am Registration ends
Marion Public Library Duck Race
starting at 11:00 am
Notice
Only advanced registrations received by July 17 will be
9:30 am
Race starts for both events
11:00 am
Duck Race – Buy your duck at
Marion Public Library prior to event.
Refreshments following race
There are no bikes, skates, rollerblades, or wheelchairs
Fees:
Before 7/17/13
consider bug spray.
Milk—Waupaca County Dairy Promotions
Discount - Econofoods food items
After 7/17/13
Volunteer
$5.00
10 and under
$10.00
$12.00
11 and over
$12.00
$15.00
(not guarantee a T-shirt)
$8.00 per person (All must register at one
time, must register by July 17)
Donations:
Water—Premier Community Bank
For More Information:
($5 for T-Shirt if you want one)
20 or more
allowed as the course has large amounts of grassy
areas to run/walk through. You might also want to
Call me to Volunteer- Phone #______________
Teams
guaranteed a T-Shirt. Marion Public Library will not be
responsible for unclaimed T-Shirts after race day.
(Fun Run— no individual times)
(Pavilion at Athletic field race day location
T-Shirt size for advanced registration: (July 17th)
Youth
Adult
Small_________
Small_______
Medium________
Medium______
Large __________
Large_______
XL Large________
Call Marion Public Library 715-754-5368 ask for
2XLarge_____
(Add $2.00)
Trinitie or email [email protected]
3XLarge_____
(Add $2.00)
Amounts Paid $__________ (Make checks payable to
Marion Public Library) - nonrefundable