The Wisconsin Council on Problem Gambling , Drug Free Communities of Fond du Lac County and
Fond  du Lac Area YScreen presents:

4th Annual "Start the Conversation" 5K Run/Walk
Let's start the conversation about addiction, mental health, and suicide.

This is an event for the entire family. Bring your dog to join the fun!

When: Saturday April 18th, 2020
Where: Lakeside Park, FDL
Registration fee: Adults  $30        * Kids (12 & under) $10

- Race day registration will be in the Pavilion.

Times:

9:00 AM   - Registration Opens
10:00 AM - 5K Run/Walk Start
11:00 AM - Kids Obstacle Course (12 & under)
11:30 AM - Awards Ceremony

T-shirts are not included with registrations after 4/5/2020.

Follow the link and view Route B for the race route at Lakeside Park! https://www.fdl.wi.gov/cofuploads/approved_race_routes.pdf
For Park Ordinance for dogs visit:  https://ecode360.com/documents/FO3072/source/LF991804.pdf

For Event Registration and Payment Online Click Here or mail in registration application below.

 

April 18th, 2020 "Start the Conversation" 5K Run/Walk Official Entry Form & Waiver
Mail Registration with check or money order to:
WCPG
1585 Allouez Ave.
Green Bay, WI 54311

NAME ___________________________________________________________________________________________________

AGE (on race day) ______

ADDRESS_______________________________________________________________________________________________

CITY/STATE/ZIP___________________________________________________________________________________________

PHONE__________________________________________________________________________________________________

EMAIL___________________________________________________________________________________________________

TEAM NAME_______________________________________________________________________________________________

SHIRT SIZE (optional, circle one)

Child S Child M            Child L             Child XL          Adult S Adult M            Adult L Adult XL          Adult XXL

*Moisture Wick shirts available (optional, additional $5, circle one)

Child S Child M           Child L             Child XL          Adult S Adult M            Adult L Adult XL          Adult XXL

T-shirts are not included with registrations after 4/5/2020.

EVENT (circle one)

5K Run/Walk             5K  Run/Walk Kids          Kids Obstacle Course

I understand that running, walking, or participating in a race is potentially hazardous. I will not enter and participate in this event unless I am medically able to do so, in good physical health, and properly trained. I agree to abide by any decision of a race official to deny or suspend my participation for any reason whatsoever. I assume all risks associated with my participation, including but not limited to: falls, contact with event participants or volunteers or vehicles, weather effects, course conditions, and traffic; all such risks being known and appreciated by me. By signing this waiver, I attest that I have read the rules of this race and agree to them. I, for myself and anyone entitled on my behalf, waive and release the event sponsors, their representatives, and successors from all claims or liabilities arising out of the participation in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of the event for any legitimate purpose.

SIGNATURE ________________________________________________DATE________________________
(parent if under 18)

No refunds for cancellations.

Event Support

Drug Free Communities of Fond du  Lac County
Fond du Lac School District

Wisconsin Council on Problem Gambling

Fond du Lac Area YScreen