Random header image... Refresh for more!

Downloadable Entry Form

San Miguel Joint Union School District
Lillian Larsen School
1601 L Street San Miguel, CA 93451
(805) 467-3216 fax (805) 467-3410

Home of the HORNETS – “Pointing the Way to Excellence”

FORTEENTH ANNUAL”BUZZ” MARATHON (USATF #CA13016RS)
At Camp Roberts
1/2 Marathon and 5K and Children under 12 1 mile RUNS
Saturday, February 15, 2014
Start Times
8:30 am Marathon & 1/2 Marathon (6:30 Walkers)
8:45 am 5K 9:30 am Kids 1 mile

FUND RAISER FOR THE ATHLETIC PROGRAMS
AT LILLIAN LARSEN SCHOOL
Serving Kindergarten to 8th grade students

RACE APPLICATION

Name _________________________________________________ Phone ___________________

Address ________________________________________________________________________

City __________________________________State ______ Zip/Country ________________

E-mail _________________________________________________________________________

Event Gender Age on race day _______
Marathon _____ Male _____
1/2 Marathon _____ Female _____
Cost: $70 by 2/1, $85 after “50 and DC” members: $50 by 2/1, $65 after
Active Military: $25 by 2/1, $40 after

5K _____ T-shirt size: circle Adult S M L XL XXL
Child S M L
Cost: $30 by 2/1, $35 after
Under 12 Children’s 1-Mile _____
Cost: $15 by 2/1, $20 after

Larsen Students: $10 by 2/1, $15 after _____

Race Day Registration begins at 6:15 AM
Please make checks payable to: Lillian Larsen School- Marathon

Please sign waiver: In consideration of the acceptance of my entry in the “Buzz” Marathon Run, I hereby waive, release and discharge any and all claims for damages, death, personal injury, disability, or property damages which may occur to me as a result of my participation in this event. This release is expressly intended to discharge in advance San Miguel Joint Union School District, Lillian Larsen School, State of California and Camp Roberts, their employees and sponsors. I agree to comply with all the rules and regulations and event instructions for the safety of me and other participants.

Signature _______________________________________________ Date _____________

Parent/Guardian waiver and release for minor:
Signature of Parent/Guardian ___________________________________ Date _______

Name of minor __________________________Relationship to minor _______________