2017 Blair Family YMCA Corporate Run/Walk

Registration Form

(Each individual will need to complete a registration form even if participating with a team)

Individual’s Name ___________________________________________________________________ Age __________________________

Company/Organization (if applicable)________________________________________________________________________________

Team Name (if applicable)______________________________________________________________________________________________

Address _____________________________________________ City ____________________Email:_____________________________________

Work Phone ______________________________________ Home Phone __________________________________________________

Please circle the best option for you: During the event, I plan on running / walking / both

Event Details

Teams must consist of at least 5 people. One team member must be an employee of the business; other members can include family and friends. This is a great opportunity to stir up friendly competition and get company recognition. Held exclusively for the corporate community; businesses and non-profit organizations form teams and participate in the Corporate Walk/Run for camaraderie, friendly competition, and celebrating with co-workers. Teams will be awarded extra points for creativity, companionship, and completing extra endurance stations along the route. Strollers are welcome. No bicycles, skateboards, rollerblades, or pets allowed.

Corporate Run/ Walk T-shirts

Your shirt order must be received by Friday May 26, 2017, with your registration.

SM _____ MED _____ LRG _____ XL _____ XXL _____ XXXL _____

Total Registration Fee

Fee: $25/person (includes t-shirt) = Total: $ 25.00

Race Information

Date: Saturday, June 10, 2017

Time: check in time at 8:15 am, race starts at 9:00 am

Location: Blair Family YMCA.

If you would like to participate but do not have a team, please indicate here and the Blair Family Y will help assign you to a team. _________________________________________________________________________________________________________________________________________

Return form to the Blair Family YMCA, 1278 Wilbur Street, Blair, NE 68008