Ea g le Ba y Ele me n t a r y
Family 5K Fun Run/Walk and Kids Fun Mile Run/Walk
Early Registration Form (1 per participant)
Date? Saturday, September 24, 2011, at 7:30 a.m.
Time? Kids Fun Mile Run/Walk begins at 7:30 a.m.
Family 5K Fun Run/Walk begins at 8:00 a.m.
Registration begins at 6:30 a.m.
Where? Eagle Bay Elementary, 1933 West Clark Lane, Farmington
Fees? $5.00 Single Kids Fun Mile Run/Walk Registration
$10.00 Single 5K Fun Run/Walk Registration
$25.00 Family Registration
(Write checks to Eagle Bay Elementary. Additional donations gratefully accepted!)
Age: Circle One: Male Female
Please circle your grade level/age division:
K 1st 2nd 3rd 4th 5th 6th Jr. High High School 18-30 30-50 Over 50
By indicating your signature, you understand, agree, warrant and covenant as follows: Knowingly, and at my own risk, I am
participating in Eagle Bay’s Family 5K Fun Run/Walk and Kid’s Fun Mile Run/Walk. I do hereby waive and release any and all claims against Eagle
Bay Elementary, Davis School District, and all event sponsors and any volunteers or officials of these organizations from any claim of injury (including
death) that I may incur as a result of my participation in the event.
I further hereby certify that I have full knowledge of the risks involved in this event, and I am physically fit and sufficiently trained to participate. If,
however, as a result of my participation in Eagle Bay’s Family 5K Fun Run/Walk and Kids Fun Mile Run/Walk, I require medical attention, I hereby give
consent to authorized medical personnel to provide such medical care as deemed necessary.
Signature of participant (or legal guardian if under age 18) Date
Additional registration forms are available on our website at
www.davis.k12.ut.us/148/site/default.asp or in the school office.