Entry Form
Race FAQs
(please print legibly)
Name: ___________________________
Race Location:
Sex: __________________ Age: ______________________
12035 Highland Dr., Oullette’s Field
Address: __________________________________________
Awards:
City, State, Zip: ___________________________________
Email: _____________________________________________
Shirt Size (circle one:
SM
M
L
Run
XL
XXL
Walk (circle one)
Waiver (MUST BE SIGNED)
In consideration of your accepting this entry, I, the below
signed, intending to be legally bound, for myself, my heirs,
my executors and administrators, waive and release any
and all rights and claims for damages I may have against
the race, and sponsors and their representatives,
successors and assigns for any and all injuries suffered by
me in said event. I attest that I will participate in this
event as a footrace, that I am physically fit and sufficiently
trained for the completion of this event. Furthermore, I
hereby grant full permission to use my name and
likeness, as well as any photographs and any record of
this event in which I may appear for any legitimate
purpose, including advertising and promotion.
Detach here and return completed entry form with payment
Phone: ____________________________________________
Top male, top female, top 3 in each age
group
Registration Fee:
$20, non-refundable (includes official tshirt). **NOTE: T-shirts for those not
running/walking can be purchased.
Registration Dates:
Mailed in entries must be postmarked no
later than August 21th. Race day registration
ends at 8:30 am.
Make checks payable and mail to:
Evans Lake Land Owners
Association-Fish Fund
143 Evans Trail Tipton, MI 49287
Questions about the race/walk? Contact
Jeff Fineske at 517-431-2277
Signature: ________________________________________
Visit our website: www.myelloa.com
Date: ______________________________________________
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“Evans Lake Land Owners Association”
Parent/Guardian Signature if under 18:
__________________________________________________________________
Catch
me if
you can!
EVANS LAKE
LAND
OWNERS
ASSOCIATION
2nd Annual 5k
Run/Walk for Fish
Saturday September 5, 9:00
am (rain or shine)