The Fremont Family YMCA’s Christian Emphasis Committee presents the 5th annual

SUN. SEPTEMBER 26, 2010

2 p.m.

1- and 2-mile walks and a 5k run

Race/Walk begins and ends at the Fremont YMCA, 810 N. Lincoln, Fremont

FEES/REGISTRATION DEADLINES - $10 if registered by Friday, September 16, 2010; $15 if registered September 17-25; $20 day of event.A t-shirt is included in the registration fee for all participants.Only those who are registered on or prior to September 16 are guaranteed a t-shirt on event day.

EVENT DAY REGISTRATION – Event day registrations will be accepted from 12-1p.m. on race day. ABSOLUTELY NO REGISTRATIONS ACCEPTED AFTER 1P.M.!!!Those who register after Sep. 16 may not get requested color so don’t wait!

DIVISIONS – There will be four run winners - adult (male and female 19 and older) and youth (boy and girl 18 and younger).

GROUPS– Do you have a group of 10 or more who would like to participate? If so, you can choose your shirt color (all shirts will have white ink and the same design). Your group can be made up of family, friends, fellow employees, etc. and not everyone in the group has to do the same distance. Each participant must complete a registration form and then if possible, please return them to the YMCA together so we know who is in what group. Shirt colors are on a first come, first served basis. When naming your group, please use your business or family name if applicable.

YMCA MISSION – God has given us the pathway to life and health through Jesus Christ and the Holy Scriptures. It is the mission of the Fremont Family YMCA to help put these principles into practice through programs that help build healthy spirit, mind and body for all.

NO YOUTH DENIED – Any child may belong to the YMCA regardless of income or family situation. If you know of a child who would like to belong, please notify the YMCA staff.

2010YMCA W.O.W. RUN/WALK REGISTRATION

(Please return to the Fremont Family YMCA by 9/16/10 to avoid late fees. PLEASE PRINT and fill out completely)

Name______Age______DOB______

Phone______Email______

Address______City______State______Zip______

1-MILE WALK /  Male /  Female /  Youth (18 and under) /  Adult (19 and older)
2-MILE WALK /  Male /  Female /  Youth (18 and under) /  Adult (19 and older)
5k RUN /  Male /  Female /  Youth (18 and under) /  Adult (19 and older)
Size(s) (please circle) Y-Sm Y-Md Y-Lg A-Sm A-Md A-Lg A-XLg A-XXLg

 I am participating in a group of 10 or more.______Name of business/group______Color of shirt

WAIVER: In consideration of your acceptance of my entry, I hereby from myself, my heirs and executors, waive and release any and all rights and claims for damages against the Fremont Family YMCA, all sponsors, meet officials, volunteers and workers from any injuries suffered by participant listed above in connection with the event. I further certify that the above parties are in good enough physical condition to participate in the event.

Signature______Date______

FOR OFFICE USE ONLY – $10 until 9/16/10; $159/17/10-9/25/10; $209/26/10

Amt. Pd.______Date Pd.______Receipt #______By______