NEWPORT-MESA SPIRIT RUN ENTRY FORM*
Last Name
First Name
Gender
 Male
 Female
Birth Date (MM/DD/YYYY)
Email Address
/
Age
/
Street Address and City
State
Zip Code
ADULT (Post High School) $35 ($5 discount Age 60+)
YOUTH (High School Aged & Younger) $25 except Toddler Trot $20
Fee DOES NOT include shirt, but tech shirt available for purchase
Fee includes cotton shirt and adult tech shirt available for purchase
 Youth 5k  Mile (age 7-19)  1/2 Mile (age 5-6)  1/4 Mile (age 4)
 Elite Mile*  Sub Elite Mile**  Dog Mile***  Open Mile  5k  10k****
 5k Family Walk
QUALIFYING TIMES/RESTRICTIONS: *Elite: men 4:30, women 5:00/mile.
**SubElite 7:00 mile ***Dogs must be on leash. 15:00/mile. 10k 13 minute/mile.
 Toddler Trot  5k Family Walk
 Twice the Fun (Spirit Run + Newport Beach Track Meet 3/31/16)
(Twice the Fun registrants must complete form on reverse)
ADD ONS: Shirts Youth registrants entitled to youth shirt but may upgrade to adult tech.
Adults may buy short sleeve tech ($7) or long sleeve tech ($10)
February 25th is last day to receive shirt order & guarantee sleeve length, size, color.
ADD ONS: Extra Races $15/race
•Maximum 2 Spirit Run races/youth; 4/adult
•Youth only may add Newport Beach Track
Meet on 3/31/16. See reverse for details.
 2nd Spirit Run race (adult and youth)
 3rd Spirit Run race (adult only)
ADD ONS:
pancakes
$6
ADULT SHORTSLEEVE TECH TURQOUISE MALE:
 sm med  lg  xl
____
ADULT SHORTSLEEVE TECH TURQOUISE FEMALE:  sm med  lg  x
Number
ADULT LONGSLEEVE TECH:ROYAL BLUE UNISEX:  sm med  lge  xl
th
 4 Spirit Run race (adult only)
breakfasts
ADULT LONGSLEEVE TECH:WHITE UNISEX:
 sm med  lge  xl
 Newport Beach Track Meet (youth only)
YOUTH COTTON SHORTSLEEVE (incl Youth fee):
 sm med  lg
Enter Your Newport Mesa Unified School/Team/Club (see reverse) OR Non Newport Mesa Unified Commission Partner School (see reverse) OR N/A
Waiver and Release
I acknowledge that running and walking can be inherently strenuous activity and that no event is without risk. I have consulted with my physician regarding
my physical capability to participate in this event. I hereby certify that I/my child am in good condition and am able to safely compete in this event I hereby release Gemini
Timing, Newport-Mesa Spirit Run, Inc., its Board of Directors, and its Management, City of Newport Beach, Jodi Book, Lisa Scolman, and Book that Events and their
employees and contractors, USAT&F, Regal/Edwards Theatres, Newport Center/Fashion Island, Rotary Club, Rotary Club of Newport-Balboa, Newport-Balboa Rotary
Club Foundation, and all of their respective members, all representative and agents of any of the foregoing, and all municipal agencies whose property and/or personnel are
used, and other sponsoring or co-sponsoring company(ies), agency(ies) or individual(s) from responsibility for any injuries or damages I/my child may suffer as a result of
my/my child’s participation in Newport-Mesa Spirit Run and Youth & Fitness Expo and/or the Newport Beach Track Meet.. I will additionally permit the use of my/my child’s
name, likeness, pictures, video, or quotes, in broadcasts, telecasts, newspapers, brochures, etc. for a perpetual period and worldwide. I also understand that the entry fee is
nonrefundable and nontransferable .As a participating athlete, I certify that all information provided in this form is true and complete. I have read the entry information
provided for the event and certify my/my child’s compliance. I understand that by providing my email address, I may receive messages from the Newport-Mesa Spirit Run and
affiliated entities. IF ATHLETE IS UNDER AGE 18:This is to certify that my son/daughter has my permission to compete in the Newport-Mesa Spirit Run and/or the Newport
Beach Track Meet, is in good physical condition, and that race officials have my permission to authorize emergency treatment if necessary.
SIGNATURE
DATE
PAYMENT SECTION Make check payable to “Newport-Mesa Spirit Run” and Mail In by March 1st to PO Box 7241, Newport Beach, CA 92658
Initial Entry Fee ($25 Age 4 - High School Ages; $20 Toddler Trot; $35 Post High School 19-59; $30 Age 60 & Older)
$
Add Extra Races ($15 per race)
$
Add Tech Shirt ($7 Adult Short Sleeve Tech $10 Adult Long Sleeve Tech) Size, color, etc. only guaranteed if order rec’d by 2/25
$
Add Pancakes ($6 per breakfast)
$
Add Donation Would you like to donate to Newport Mesa Unified School, Club, or Team identified above? If yes, enter amount.
$
Add Donation Would you like to donate to Spirit Run’s Running Programs (free entries to underprivileged)? If yes, enter amount.
$
TOTAL FEES
$
Administrative Use Only
Bib Number
Race(s)
Amount Paid
Payment Type
$
❑ Cash ❑ Check ❑ CC
*For complete details on all races, including description, pricing, schedule, awards, etc., visit www.nmspiritrun.org.
NEWPORT MESA UNIFIED SCHOOL DISTRICT PARTICIPATING SCHOOLS, CLUBS & TEAMS
SCHOOLS
College Park Elementary
Corona del Mar High School
Corona del Mar Middle School
Costa Mesa High School
Costa Mesa Middle School
Davis Magnet
Eastbluff Elementary
Ensign Intermediate
Harbor View Elementary
Mariners Elementary
Newport Coast Elementary
Newport Harbor High School
Newport Heights Elementary
Paularino Elementary
Tewinkle Middle School
Victoria Elementary
CLUBS AND TEAMS
Corona del Mar Vocal Music
Corona del Mar Girls Lacrosse
Newport Harbor High Girls Lacrosse
Okazaki Student Exchange
SCHOOL COMMISSION PARTNERS OUTSIDE NEWPORT MESA UNIFIED
Don Juan Avila Elementary School
Harbor Day School
Our Lady Queen of Angels Catholic School
St. John the Baptist School
Tijeras Creek Elementary School
YOUTH Twice the Fun (Spirit Run + Newport Beach Track Meet)
Friday 3/31/16 Corona Del Mar High School
ENTRY FORM
The following are the events for each age division (i.e., year of birth).
Competitors are allowed 2 Running and 1 Field OR 2 Field and 1 Running.
N MAR2017EWPORT BEACH TRACK MEET REGISTRATION - MARCH 31, 2017
Born 2002
or 2003
Born 2004
Born 2005
Born 2006
Born 2007
Born 2008
Born 2009
Born 2010
100 m dash
200 m run
400 m run
1600 m run
softball throw
long jump
high jump
shot put
100 m dash
200 m run
400 m run
1600 m run
softball throw
long jump
high jump
shot put
100 m dash
200 m run
400 m run
800 m run
1600 m run
softball throw
long jump
100 m dash
200 m run
400 m run
800 m run
1600 m run
softball throw
long jump
100 m dash
200 m run
400 m run
800 m run
1600 m run
softball throw
long jump
50 m dash
100 m dash
200 m run
400 m run
softball throw
long jump
50 m dash
100 m run
200 m run
400 m run
softball throw
long jump
50 m dash
100 m run
200 m run
softball throw
long jump