Turn-A-Row Gymnastics Presents

Please Print Information Clearly

Name ____________________________________________Age______________
Phone_________________________ Email_______________________________
Address____________________________________________________________
City___________________________ Postal Code__________________________
ENTRY FEE Adult - $15- Includes Glow Gear
Age 6-15- $10- Includes Glow Gear
5 & Under FREE Glow Gear available for purchase

PRE-Register to get the Coolest Glow GEAR!!!!

Optional Collect Pledges to pay your entry and win Prizes!! Please make all
cheques payable to Turn-A-Row Gymnastics

Name

Free Supper @ $20, Glow Gear and Prizes at $30, $50, $75
and $100
Prize for most money Raised

Amount

Total

Collected

Turn-A-Row Gymnastics Ready Set Glow 5K Walk/Run Sept.

12/2015
Waiver and Release:
I understand that walking and running is a potential hazardous activity. I verify that I
am medically fit and capable of participation in the Ready, Set, Glow! 5K Walk/Run.
I, intending to be legally bound for myself, heirs, next of kin, and personal
representatives, do hereby release Turn-A-Row Gymnastics and any and all
organizers, sponsors, and others involved with this event and their representatives,
successors and assigns, from any and all liability arising from illness or injuries I
may suffer as a result of my participation in this event. Further, I grant full
permission to any and all of the foregoing to use photography, videotapes, motion
pictures and recordings of me, and/or any others record of this event for legitimate
purpose.
I understand and agree to this waiver and release.
Signature: _________________ __________________________________________Date:
__/____/____
If Under the Age of 18 Parent or Guardian Signature Needed
Parent Signature: ____________________________________________________Date:
___/____/____

Completed forms can be sent with Payment to:

Turn-A-Row Gymnastics
Box 751
Kelvington,SK
S0A 1W0

OR dropped off at the Gym.