Ray’s 5K - Registration Form

Mail To:  NEWLHS – Ray’s 5K
   
             1311 S. Robinson Ave.
   
             Green Bay, WI  54311

Please make checks payable to NEWLHS.  Questions? Call Jeff Luepke @ 265-3192

Categories  (please check) 5K Run Age Divisions (please check)
__ 5K Run (3.1 mile)  __ Grades 1-5    __ Grades 6-8     __ High School
__ 5K Walk (3.1 mile)  __ 19-29      __ 30-39      __ 40-49      __ 50+ 
__ Kid’s Run (Ages 3-6, 1/4 mile)
__ Kid's Run (Ages 7-10, 1/2 mile)

(Please Print)
Name: _____________________________________________________________
 

Address: ___________________________________________________________ 

City: _______________________________ State: __________ Zip:___________ 

Phone: _____________________________ E-Mail: ________________________________ 

___ Male ___ Female 

Shirt Size 

Adult    __ S    __ M    __ L    __ XL    __ XXL ($2 extra) 

Child    __ S    __ M    __ L 

Please Pre-Register to Guarantee Shirt Size 

Waiver : In consideration for your acceptance of this entry, I hereby release, discharge from all liability and agree to hold harmless, NEWLHS Blazer Alumni Association, NEW Lutheran High School, City of Green Bay, and all sponsors, from any claims for damages that may happen to me while participating in this event. This hold harmless agreement shall be binding on my heirs, personal representatives and assignees. I attest that I have read, fully understand and accept the aforementioned terms of participation. 

________________________________________________________________

Signature: (All persons under 18 MUST have parent/guardian’s signature)