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Zoo Run Run Registration Form

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					                                                               Tampa’s Lowry Park Zoo’s “Zoo Run Run”
                                                                          Saturday, September 12, 2009
                                                                                          Check in 7-8 a.m.
                                                             5K Walk/Run at 8 a.m. - “Fun Run” at 9:15 a.m.
                                                              Come see why we’ve been named the #1 Zoo in the USA at Tampa’s Lowry
                                                              Park Zoo’s SEVENTH annual “Zoo Run Run” taking you throughout the Zoo
                                                              and along the scenic Hillsborough River.
                                                              Race features:
                                                              • Food and beverages during post-race reception
                                                              • 5K Awards - top 3 finishers M/F in each category & overall M/F
                Sponsored by:                                 • Race T-shirt
                                                              • Free admission to the Zoo for the day (for participants)
                                                                     Tampa’s Lowry Park Zoo • 1101 West Sligh Avenue
                                                                                   Tampa, Florida 33604
                                                                       (813) 935-8552, ext. 239 for more information.
                                                                              FAX your form to (813) 932-1861

                                 ENTRY FORM                                                                  Early Bird Registration
Participating in:                5K                    Fun Run                                                (in by August 28th)
Name:                                                                                                                   5K - $20
                                                                                                                    Fun Run only - $10
Address:                                                                                                Participants recieve an extra ticket for guests or
City, State, Zip:                                                                                        to use on a different date.Groups of 10 or more
                                                                                                          get a $5 discount per entry. (Discount does not
Phone:                                                                                                  include Fun Run) Early Birds are guaranteed an
                                                                                                        event t-shirt, eligibility for awards and any other
E-mail:                                                                                                   gifts and prizes associated with the event. Fun
T-Shirt Size:                                  Age:                                                          Run for kids 11 and younger distance of
                                                                                                                Fun Run is just under 1/2 mile.
                                                                                                                   After August 28th
     YES! Please contact me. My company is interested in being a
                                                                                                                        5K - $25
     sponsor and having a group for this event.
                                                                                                                    Fun Run only - $10
                            PAYMENT                                                                             After the August 28th Early Bird
                                                                                                         registration, additional free tickets to Tampa’s
                                                                                                          Lowry Park Zoo and Group Discount is not
   Check enclosed made out to Tampa’s Lowry Park Zoo                                                     included. Day of walk-up registration, t-shirts
    in the amount of $ _______.                                                                           are while supplies last. ALL PARTICIPANTS
                                                                                                        RECEIVE DAY OF ADMISSION TO THE ZOO
    MasterCard            Visa         Discover      AmEx
                                                                                                                      THE DAY OF RACE.
 CARD #:                                                                                                       Fun Run for kids 11 and younger.
 Exp. Date:                    Signature:
 Total Amount to Charge: $
In consideration of my entry into the ZOO RUN RUN 5K and the Fun Run to be held on September 12, 2009, I release from their own negligence the
Lowry Park Zoological Gardens, Lowry Park Zoological Society, Lowry Park Endowment Foundation, the City of Tampa, and all of their sponsors,
officers, directors, and members of each of said organizations, their respective employees and agents and any other entity or individual(s) who are in
any way connected with this event or which is in any way related to this event. I understand that this release extends to myself, my heirs, my assigns
or any other personal representative. I represent that I have trained for this event and am physically of sound body and mind to participate in this
event. I have read the information contained in this brochure and understand the risks associated with participation in this event. I also realize that
this release is relied upon by the persons above in permitting me to participate. I also know that although traffic control and police protection is
provided I will assume all risks of running in traffic. I agree to drug testing in accordance with USATF rules IAFF Rule 144 if selected as a testing site.
Further, I hereby grant full permission to any and all of the foregoing to use any photographs, videotapes, motion pictures, recordings and any other
record of this event for legitimate purpose. I understand that if I am under the age of 18 that I must have the permission of my parent or legal guardian
in order to participate in this event. I HAVE READ THE ABOVE RELEASE AND UNDERSTAND THAT I (MY CHILD) IS ENTERING THIS
EVENT AT MY (HIS OR HER) OWN RISK.                    Check here if you do not want to receive any email information from Tampa’s Lowry Park Zoo about
events, sales, animals and other news. By signing below, you also acknowledge THIS EVENT IS RAIN OR SHINE, and is a fundraiser for Tampa’s Lowry
Park Zoo, therefore NO REFUNDS OR EXCHANGES.
Signature: ______________________________________________________ Date:                                     ___________________________________
                    (Parent or Legal Guardian)
Child’s Name if under 18:

				
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