Carondelet Get Moving Tucson Registration Form

Print this form, fill it out, and mail it with a check payable to the
Southern Arizona Roadrunners to this address by October 8th, 2007:

Southern Arizona Roadrunners
Get Moving Tucson
PO Box 64215
Tucson, AZ 85728-4215


Please circle one:   10 mile run 	5k Run 	 	5k walk


Last Name _____________________ First Name _____________________

Mailing Address ________________________________________________

City __________________________  State ______  Zip _____________

E-mail _________________________________________________________

SAR Member Y/N ______       Carondelet Employee Y/N ______

Telephone ______________   Age on 10/21/07 _______    Sex  ____


Registration Fee Schedule

10 Mile Running Race

   SAR Member by 10/8/07                         $20  _________
   Non Member by 10/8/07                         $30  _________
   All after 10/8/07                             $40  _________

5K Run or Walk *

   SAR Member by 10/8/07                         $12  _________
   Non Member by 10/8/07                         $15  _________
   All after 10/8/07                             $25  _________
*Children under 12 are free (no shirt)

SAR Membership (annual, individual)              $20  _________


TOTAL FEES PAID                                     $  _________


Please read and sign the following:

Waiver
In consideration of the acceptance of this entry, I hereby, for myself
and my heirs, executors and administrators, waive any and all rights,
claims and damages I may have against the sponsors, coordinating groups,
the Southern Arizona Roadrunners, the City of Tucson, Pima County, and
any individuals associated with said event. Also, none of the above is
responsible for the loss of personal items nor any other form of
aggravation in connection with said event. I have been warned I must
be in good health to participate in the event.  I also give permission
for the free use of my name and picture in any broadcast, telecast,
digital or print media account of this event. In filling out this form,
I acknowledge I have read and fully understand my own liability and do
accept the restrictions.


X ________________________________________________________________
   Entrant's Signature                         Date
   (Parent or Guardian's Signature if under 18)