Dig It Dash (5K run/walk)

*Start & Finish at Dig It Kingman Community Gardens *Post Race Refreshments and Award Ceremony *Awesome Dig It Hand Crafted Awards First Annual DIG It Dash Saturday * April 2, 2016 * 8:00 AM 5K Run/Walk Race Day Highlights: c 2301 Lillie Avenue, Kingman, AZ (Corner of Lillie and Harrison, off Hualapai Mtn Road) *Post Race Refreshments and Award Ceremony All Registrants Eligible for Prizes Race Fee: $25 prior to March 26th *Must Be Present To Win* $30 March 26th-April 1st $35 Race Day Awesome Dig It Hand Crafted Awards Early Packet Pick-Up (Corner of Lillie and Harrison) *Top Male & Female Overall Parking Lot at Dig It Community Gardens *Top Master Male & Female (40+) 5:00-7:00 PM-2301 Lillie Avenue *Top 3 in Each Age Division Race Day Registration: 6:30-7:30AM For Additional Information Contact: Make Checks Payable To: DIKCG Denise at 928-530-8072 Mail to: P.O. Box 3983, Kingman, AZ 86402 Email: digitkingmandn@gmail.com OR register online at www.active.com OR in person until April 1st at Chicago Title Co., 2699 E Andy Devine PROCEEDS BENEFIT DIG IT KINGMAN COMMUNITY GARDENS --------------------------------------------------------------------------------------------------------- PLEASE PRINT Official Entry Form Make check payable to DIKCG. Mail to P.O. Box 3983, Kingman, AZ 86402 -3983 OR register online at www.active.com OR in person until April 1st at Chicago Title Co., 2699 E Andy Devine, Kingman, AZ Name:________________________________________________________ Age Division (Circle one) 14 & under; Address:_____________________________________________________ 15-19 yrs; 20-29 yrs 30-39 yrs; City, State:___________________________________________________ 40-49 yrs; 50-59 yrs 60 & over D.O.B.________________________ Age:______________ Sex: M F Phone:________________________ E-Mail:______________________ T-Shirt size: (circle one) S M L XL XXL In Consideration of my acceptance of this entry, I hereby release the Dig It Kingman Community Gardens, and The City of Kingman, its agents, officers, employees, and volunteers, and coordination groups, sponsors, and any individual associated with this event, and will hold them harmless for any and all injuries suffered in connection with said event. I further hold none of the above responsible for the loss of person items or any other forms of aggravation associated with said event. I have been warned that I must be in good health to participate and I acknowledge that I am an amateur in such events. I also give my permission for the free use of my name and picture for use in any broadcast, telecast, brochure, or media coverage of this event. In filing out this form, I acknowledge that I have read and fully understand my own liability and do accept the restrictions. Signed:__________________________________________________________________________ Dated: __________________________ Parent signature if participant Is under 18 years of age: _____________________________________________________ Dated: __________________________