Child Abuse Prevention Month
5K Fun Run/Walk & Kids Walk
Saturday, April 25 – 9 a.m.
Paul Ream Wilderness Park
| Registration Forms should be turned in to Susan Knadler at 150 E Center Street, Suite 5100, Provo, UT 84606. Additional registration forms can be obtained by e-mailing sknadler@utah.gov, or picking them up at the Provo Police Department. |
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Registration by Mail must be received by Monday, April 20. The entry fee is $15 and $5 for kids 12 and under. Checks should be made out to United Way. |
| Registration after April 20: The entry fee after April 20 is $20 and $8 for kids 12 and under. Registration and Check-in will start at 8 a.m. the day of the race. |
Start Time: The race will start at 9 a.m. at 1600 W 500 N in Provo (Paul Ream Wilderness Park). Please arrive by 8:30 a.m. |
| T-shirts will be given to everyone who participates in the race. LOTS OF AWESOME RAFFLE PRIZES!!! Proceeds will be used to for child abuse prevention activities. |
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| First Name Last Name DOB____________ |
| Address City State Zip_______ |
| E-mail Address_______________________________________________________ |
| Sex: M F (Circle) T-Shirt size: S M L XL XXL (Circle) |
| RACE: 5K or Kids Race (Circle) Adult or Youth Shirt (Circle) |
| In consideration of my entry, I waive and release the above race and its sponsors and others directly or indirectly involved in the events from all rights, claims, liabilities, damages, pain and illness suffered by me while participating in the race. I attest and verify that I am physically fit and have trained to participate in the race. I also understand that all registration fees are non-refundable. |
| Signature_________________________________ Date______________________ (If under 18, signed by parent or guardian) |