to a paper registration form

2015 Door County YMCA Labor Day
Run & Duathlon
Saturday, September 5, 2015
(Ages 15 & up)
$38 before July 15
$43 before Aug. 15
$48 Aug. 16 through race day
$63 for pairs registration
5k Run/Walk
$15 Youth (Ages 8-17)
through race day
$22 before July 15
$27 before Aug. 15
$32 Aug. 16 through race day
1/2 Mile Kid’s Run
Ages 1 - 8
$10 through race day
Schedule of Events
Packet Pickup available
Friday, August 29,
6:00 am - 7:30 pm,
or on race day
7:00 am
Race Day Registration
8:00 am
All events start and finish at the
Northern Door Program Center.
Please park at Gibraltar High
School. Bike helmets required for
duathlon & headphones prohibited
for duathlon. Must be present to
receive medals.
9:45 am
5k Run/Walk
10:15 am
Kid’s Run
Make Checks Payable to Door County YMCA and return to: Door County YMCA - Labor Day Run
3866 Gibraltar Road, Fish Creek, WI 54212 • Phone (920) 868-3660 Fax (920) 868-9970
r Male r Female
Date of Birth:
Age on Race Day
Email Address:
Race: r 5K Run/Walk
r 1/2 Mile Kid’s Run
r Duathlon r Duathlon Pairs Relay
T-Shirt Size: r Youth S rYouth M rYouth L r Adult S r Adult M r Adult L r Adult XL r Adult XXL
Emergency Contact:
Fee Enclosed: r $______________
Please sign waiver of liability on reverse side. A signed waiver is required of each race participant.
***Please sign waiver of liability below. A signed waiver is required of each race participant.
Waiver of Liability
Liability: I understand the physical activities in which I, my child, and/or my team participate(s) in with the Door County
YMCA include, but may not be limited to running/walking and biking. I agree to assume all liability and release the Door
County YMCA and any other associated parties for any liability for the risk of injury, illness or death on account of my and/
or my team’s presence in the athletic competition whether caused by negligence of the Door County YMCA or another person
on the premise or at the sponsored activity.
Photo/Talent Release: I hereby irrevocably release, consent and authorize the Door County YMCA and its agents to use
my and/or my teams photograph/likeness/voice, as it pertains to my and/or my team’s participation with the YMCA, in any
manner for promotional efforts without expectation or right to any reimbursement in connection with its use.
Race cancelled due to severe weather. No refunds.
Participant/Parent Signature: