ALP FUN RUN REGISTRATION

ALP FUN RUN REGISTRATION
Name: _________________________________________
Address: ________________________________________
Phone: ________________
E-mail:_________________
Family members (if registering as a family):______________
Registration Costs:
______ (# of runners) x $10 = ______
OR
Family x $30 =_____
_____ (# of T-shirts) x $10 = ______
(Shirt sizes please: ________________) TOTAL=______
(Checks payable to ALP of Juneau County)
I the undersigned, know that the event I am entering carries a
certain amount of risk and personal injury or damage. I am aware that a
running event requires advanced training. I certify that I am physically
ready for this event. I herby waive and forfeit all rights I might have
to file suit or make claims against the sponsoring group and all persons
connected with this event, for injuries suffered by me at this event.
______________________________________________
Signature(s)
Saturday
2014 FUN RUN
August 16, 2014
8 am
Registration 7:30 am
A ccept… the challenge
L
ead….with confidence
Juneau County
Fairgrounds
F
P
ledge…to make a difference!
ALP FUN RUN
August 16, 2014
A LOCAL FUNDRAISER TO SUPPORT
GREAT IDEAS IN JUNEAU COUNTY
The Advanced Leadership Program began in 2003 and provides researchbased educational opportunities for personal and professional growth
through the UW-Extension. ALP provides education to cover a multitude of
issues facing Juneau County. The goal of this fundraiser is provide
continued support to ALP and to any local non-profit of Juneau County willing
to demonstrate a need for the greater community.
2 mile run/walk
10 K RUN
Cost $10 or family
for $30 maximum
Pre-ordered
T-shirt cost $10
Mail registration
form (on back) to:
Karen Patton
W1650 64th Street
Lyndon Station, WI
53944
608-548-8266
[email protected]
hughes.net
[email protected]