Let’s start the conversation about addiction!

 

The Wisconsin Council on Problem Gambling & Drug Free Communities of Fond du Lac County presents:

Start the Conversation: 5K Run/Walk

When: Saturday April 8th, 2017

Where: Lakeside Park, FDL

Registration: Begins December 1, 2016.

Registration fee: $25     $30 after March 15, 2017      Kids (12 & under) $10    $15 after March 15, 2017

Times:
9:00 AM - Race Day Registration Opens
9:30 AM - Kids 100 Yard Race (12 & under)*Free
10:00 AM - 5K Run/Walk Start
11:30 AM - Awards Ceremony

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 Event Registration and Payment Online Click Here

or mail in registration application below.

April 8th, 2017 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___________________________________________________________________________________

SHIRT SIZE (optional, circle one)                         Add $5 for a Dri Wick T-Shirt (Adult Only)    
Child S       Child M       Child L       Child XL       Adult S       Adult M       Adult L       Adult XL

EVENT (circle one)       5K Run       5K Walk       Kids 100 Yard Race

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.

Sponsors

Conversation ($2000)
Motivation ($500 - $1,999)

Strength ($250 - $499)

Balance ($100 - $249)

Creative Calm Counseling, LLC
Dear Prudence Shoppe
Xterior's Plus, LLC

Recovery (up to $99)

Printing

Wisconsin Council on Problem Gambling

Event Support

Fond du Lac Running Club
Drug Free Communities of Fond du  Lac County
Fond du Lac School District
Wisconsin Council on Problem Gambling
New Vision Signs & Decals