Water Walk Enrollment Form

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www.eccosalon.com
Ecco Salon
Water Warriors 2015!
Fitchburg 4 mile Run/Walk on Sunday May 3 @ 10:00am.
$20 per person
$15 student rate w/ valid id
0-14yrs old are free
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Enrollment fee is 100% donated to the Alliance for the Great Lakes. A local organization
working to help keep our Great Lakes clean!
Early enrollments will receive an event t-shirt!
Please arrive at Ecco Salon 30-60min prior to the event start time. Check in is required to obtain
your t-shirt. Underground parking is available at the East and West entrance of the Agora
building.
Enrollment fee can be paid by cash or check. Please make checks payable to The Alliance for the
Great Lakes.
After party directly after the run/walk. Look for details soon!
Please fill out the information below and mail or drop off at, Ecco Salon, 5500 E Cheryl
Pkwy. Fitchburg WI 53711. Don’t forget your enrollment fee!
NAME ____________________________________________
ADDRESS__________________________________________
CITY/ST ______________________________ ZIP__________
PHONE ____________________________ AGE ______
Male Female (circle one)
T-shirt: Small Medium Large
X-Large XX-Large
(circle one)
WAIVER
Participants must sign the following prior to Ecco Salon’s Water Warriors Run/Walk 2015.
I assume all risks and hazards of the conduct of the program, recognizing the hazards attendant to any
road walking/running event. Realizing no insurance coverage is provided for participants. I will assume
financial responsibility for any cost relating to accident/injury or damages. I do hereby release and hold
harmless Ecco Salon, the City of Fitchburg, this program from any and all claims, injuries, damages,
losses or suits, including attorney fees, arising out of or in connection with the program.
I grant full permission to use any photographs taken during the event for future use by Ecco Salon for
informational and or promotional use. I have read this statement and my signature below verifies my
acceptance of these conditions.
Signature____________________________Date__________________
(parent/legal guardian, if under 18 years of age)
Ecco Salon - 5500 E. Cheryl Pkwy #120, Fitchburg, WI 53711. Ph. 608.273.ECCO(3226)
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