Child Abuse Prevention Month
5K Fun Run/Walk & Kids Walk
Saturday, April 19th – 9:00 a.m.
1600 West 500 North, Provo, UT
Registration Forms should be turned in to Susan Knadler at 150 E. Center, Suite 5100, Provo, UT, 84606. Additional registration forms can be obtained by emailing , or they can be picked up at the Provo Police Department.
Registration by Mail must be received by Wednesday, April 16th, 2008. The entry fee is $15.00 and $5.00 for kids 12 and under. Checks should be made out to United Way.
Registration after April 16thth- The entry fee after April 16th is $20.00 and $8.00 for kids 12 and under. Registration and Check-in will start at 8:00 a.m. the day of the race.
Start Time - The race will start at 9:00 a.m. at 1600 West 500 North in Provo (Paul Reams Wilderness Park). Please arrive by 8:30 a.m.
T-shirts will be given to everyone who participates in the race. LOTS OF AWESOME RAFFLE PRIZES!!! Proceeds will be used to for Child Abuse Prevention Activities.
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First Name Last Name DOB____/_____/_____
Address City State Zip_______
Email Address_______________________________________________________
Sex: M F (Circle) T-Shirt size: S M L XL XXL (Circle)
RACE: 5k or Kids Race (Circle) Adult or Youth Shirt (Circle)
In consideration of my entry, I waive and release the above race and its sponsors and others directly or indirectly involved in the events from all rights, claims, liabilities, damages, pain and illness suffered by me while participating in the race. I attest and verify that I am physically fit and have trained to participate in the race. I also understand that all registration fees are non refundable.
Signature_________________________________ Date______________________ (If under 18, signed by parent or guardian)