Stampede for Students 5k Fun Run/Walk & 3k Walk Sat May 4, 2013 Oregon State Fairgrounds Come join in the fun at Western Mennonite School’s 5k fun run/walk and 3k walk in conjunction with our annual benefit auction. By participating in this event, you will be helping the students of Western continue to receive a high quality education in a Christian environment. Afterwards, join us for our 41st annual benefit auction.
Runners and Walkers
-Receive Stampede for Students shirt (guaranteed for first 30 entry forms) -Door prizes given out after the race; fruit and drinks provided WHEN:
Saturday, May 4, 2013 starting at 8:00AM. Registration will be at 7:15AM behind the Jackman Long building. Race will be held rain or shine.
WHERE:
The entire course will be located on the Oregon State Fairgrounds, maps provided
FEE:
$15 with registration received or postmarked by April 26, 2013. $20 for all registration thereafter, including race day registration. Optional: Participants are also encouraged to raise money via sponsors and bring their collections to the registration table on race day.
INFORMATION:
Contact Ben Handrich at (503) 363-2000, or look us up at www.westernmennoniteschool.org
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -(Detach along line and send form)- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Western Mennonite 5k/3k Race Registration Form Age on Race Day May 4, 2013
Select event: 5K Run/Walk________ 3K Walk_________ T-Shirt size (please circle one) S M L XL XXL (adult sizes) Phone Number: ( ) City: State: Zip: Circle one: Female Male Choose one Option: 1.____ Registration amount enclosed. $15 when received or postmarked by April 26, 2013. $20 for all registration thereafter, including race day registration. Name: Street Address:
(Please make checks payable to Western Mennonite School)
2. ____ I will raise money by getting my own sponsors. (details on the attached sheet) Race Waiver “I, the undersigned, represent that I am medically fit and have properly trained to participate in this event. I hereby for myself, my heirs and executors, release any and all claims or right to make claims against all of the sponsors, organizers, employees, and volunteers associated in any way with the Western Mennonite Stampede for Students. I recognize and assume the risks inherent in running a road race, including but not limited to the risk of injury associated with strenuous physical exercise, contact with other participants, falls, running near traffic, and the risk of uncertain weather including heat and humidity. This release extends to all claims of every kind or nature whatsoever, foreseen or unforeseen, known and unknown. I grant permission for any and all of the foregoing to use any photographs, video tapes, recordings, or any other record of this event for any purpose whatsoever.” Signature_____________________________
Parent's Signature_____________________________ Date _______________ (If under 18 )
Western Mennonite 2013 Stampede for Students Sponsorship Form Thanks so much for your participation in the third annual Stampede for Students! We are really excited that you are “going the extra mile” to raise even more for the students at Western Mennonite School! The goal is to get as many sponsors as you can. Ask family, friends, neighbors, co-workers, schoolmates, etc. for donations. Tell them about Western and how it has impacted you and/or your family! (Total sponsor donations should be greater than the $15 entry fee.) Please collect all pledge money by Friday, April 26, 2013. Bring the money when you check in for the race on Saturday, May 4, 2013. The person with the highest sponsor contribution total will have first choice from the door prize table! (Please have all $ collected & turned in on race day to be eligible to receive the award.) The space below is to list your sponsor’s name, address & their contribution. Checks should be made to WMS & labeled “Stampede For Students” on the memo.
Mail to: Western Mennonite School, 9045 Wallace Rd NW, Salem, OR 97304 (Attention: Ben Handrich)
Name of Sponsor Address (street, city, state, zip)
Amount
1
$
2
$
3
$
4
$
5
$
6
$
7
$
8
$
9
$
10
$
11
$
12
$ Total Amount Collected $
Please collect and bring all sponsorship money to the registration table on the day of the race. Please make copies of this form if you need more space.