Mosinee Chamber of Commerce


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Little Bull Falls Log Jam Woodsman 5k Family Fun Run/Walk A portion of the proceeds goes to the Mosinee High School Cross Country team Race sponsored by the Mosinee Area Chamber of Commerce and City of Mosinee When: Saturday, August 14th, 2010 Registration at 8 am Race begins at 9 am Where: River Park, Mosinee Strollers are allowed. No rollerblades or bikes. Registration Fees: $12 After July 30 fee is $15 T-shirts, medals, and post-race refreshments Race Director: Mosinee Area Chamber of Commerce 715-693-4330/macoc@mtc.net
Name
Address
City
State
Zip
Age day of race
Sex	Male Female
T-Shirt Size	Small Medium Large Extra-Large
I know that running or otherwise participating in a road race is a potentially hazardous activity which would cause injury or death. I understand that I should not enter or participate in these events unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to any aspect of my participation in this event, including the right of any official to deny or suspend my participation for any reason whatsoever. I assume all risks associated with participating in these events, including but not limited to: falls, contact with other participants, effects of weather, including high heat and/or humidity, traffic, and the conditions of the road, all such risks being known and appreciated by me. I understand that bicycles, skateboards, and rollerblades/skates are not allowed in this event and I will abide by this guideline. Having read this waiver and knowing these facts and in consideration of your accepting my registration, I, for myself and anyone entitled to act on my behalf, waive and release the organizers, Mosinee Chamber of Commerce, Mosinee Parks, and their sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event, even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission to all of the foregoing to use any photographs, motion pictures, recording, or any other record of these events for any legitimate purpose. RACE HELD RAIN OR SHINE- NO REFUNDS, EXCHANGES, OR TRANSFERS
I (or legal guardian if under 18) have read and agree to above

Total Cost	$15.00
Payment Method:	Send me Invoice Paypal (preferred)

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