Wednesday, March 5, 2014

Registration for for Palisade BEE Festival, Zoo "BEE"lievers 5K walk/run

Zoo’BEE’lievers 5K RACE REGISTRATION
FEE …. $25,  DAY OF RACE, $30
PRE-REGISTRATION includes Tee-shirt
REGISTRATION BY MAIL DUE APRIL 5
Include $2.00 extra,for shirt sizes XXL & XXXL
(No guarantee shirt size for registrations
received after April 3.)
Send this form with check/money orders
To: Children’s Nature Center
       404 Jurassic Ave. A
       Fruita, CO 81521
Attention: Brenda Evers, Race Director
Confirmation of registration
Text Box:  By phone or email.
CASH, CHECK, MONEY ORDER
AGE GROUPS
Circle age on 4/12/2014
Under 14            41 - 50   
14 – 20             51 - 60
21 – 30             61 – 70
31 – 40             71 – 80+

ZOO’BEE’lievers 5K WALK/RUN

RACE BEGINS AT 10 A.M.
AWARDS BEGIN 11:30
Check in at Registration for course starting point.
Name___________________________________
Address_________________________________
City____________________ Zip_____________
Phone ________________ cell_______________
Email___________________________________
Age on the Race day_________  Sex__________
Shirt size   XS   S    M    L     XL   XXL   XXXL
   Remember:($2 extra for XXL & XXXL sizes)
WAIVER OF LIABILITY: READ AND SIGN BEFORE MAILING                  
In consideration of the acceptance of my entry for the
ZOO’BEE’lievers 5 K RACE/WALK, APRIL 12, 2014, I understand 
and agree that any bodily injury, death or loss of personal property 
and expense as a result of my, or the city’s
Negligence is my responsibility. As lawful consideration for 
being permitted to participate in this run, I release from 
any legal liability and agree not to sue, file claim against the 
property of, or prosecute; and to indemnify and hold harmless 
Palisade and all its officers, agents and employees for any and 
all liability, injury, or death caused by or resulting from my 
voluntary participation in the previous mentioned activities. I 
authorize and consent to the publication of myself, whether 
by TV, newsprint, written advertisements or otherwise, of 
any materials contained in my name or picture for participation 
in any event.
Signature of participant ________________________date_______
Signature of parent or guardian_____________________date____

Children's Nature Center
ZOO’BEE’lievers 5K Walk/Race 2014
@ Palisade International Honey Bee Festival

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