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or register @ the following:
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PRINT AND MAIL IN REGISTRATION FORM
 2010 Fall 
GO FAR 5K Race
November 6, 2010
Mail TO: MAKE CHECKS
GO FAR PAYABLE TO:
2432 N. Old Greensboro Rd GO FAR
High Point, NC 27265
Last Name: __________________ First Name: _________________Age on race day_____
Address: _______________________City _____________ State:_______ Zip code______
CIRCLE ONE: Male or Female Email Address: ______________________________
Phone number _______________Emergency phone_________________
5K RACE CATEGORY – SELECT ONE
_____$20 through October 22, 2010 _____$25 after After October 22, 2010 _____ $25 Race Day
Please provide the school the participant or family member is affiliated with:___________________
Please check one of the following:
___I am a GO FAR Kid participating in a school program
___I am a parent, sibling or other family member of a kid in a GO FAR program
___I am a teacher who works with GO FAR or at a school doing GO FAR
___I am not part of GO FAR I am from the community
___None of the above
NOTE: GO FAR IS A PARTICIPATORY FITNESS PROGRAM. WE AWARD MEDALS TO ALL
FINISHERS, BUT NO AGE-GROUP OR OVERALL AWARDS.
T-SHIRT—SELECT ONE –PLEASE CIRCLE
Youth Medium Youth Large Adult Small Adult Medium
Adult Large Adult XL Adult 2X (add $2 for XXL)
Don’t wait until the last minute to register! GO FAR cannot guarantee you receive a race
T-shirt if you register after October 22, 2010
Race Waiver:
I know that running a race can be a hazardous activity. I should not enter and run unless I am medically able and properly trained. I assume all risks associated with running in this race, including, but not limited to, falls, contact with other participants, the effects of weather including high heat and humidity, ice, traffic, lightening, high winds, and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts, I for myself and anyone entitled to act on my behalf, waive, release, and will hold harmless GO FAR inc, the race organizer, all other sponsors, all volunteers, staff, officers, for all claims, liabilities of any kind arising out of or related to my participation in this race. Athlete acknowledges and agrees that the organizers of the, in their sole discretion, my delay or cancel the race or related activities for any reason. The participant hereby assumes all risks of loss, damage, or injury that may be sustained by him/her while participating in the GO FAR 5K. The participant agrees to the use of his/her name and photograph in all media and promotion efforts without compensation. IF THE PARTICIPANT IS UNDER AGE 18: I, the undersigned parent/guardian, agree that my son/daughter has my permission to participate in that the parent/guardian has read the foregoing Race Waiver and by signing below intentionally and voluntarily agrees to its terms and conditions. The parent/guardian further represents that my son/daughter is in good physical condition and is able to safely participate in this race. Parent / guardian must also sign below for the entrants under the age of 18. By signing, parent/guardian agrees to the same conditions required of the Participant.
PARTICIPANT HAS READ THE FOREGOING AND INTENTIONALLY AND VOLUNTARILY ACCEPTS THIS RACE WAIVER
Signature of Participant ____________________________________________Date________
Parent or guardian must sign for runners under 18 y/o_____________________Date _______
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