Mail to:
AA Sports, Ltd.
4836 SW Western Ave
Beaverton, OR 97005

Event - Choose One (entry fee includes commemorative T-shirt):

- 5K Run/Walk $20 on or before Oct 4, 2009 5K Run/Walk $25 on or after Oct 5, 2009 10K Run/Walk $25 on or before Oct 4, 2009 10K Run/Walk $30 on or after Oct 5, 2009 ½ Marathon Run/Walk $40 on or before Oct 4, 2009 ½ Marathon Run/Walk $45 on or after Oct 5, 2009 1K or 2K Kids' Runs are only $12 for registration up to race day!
First Name / MI / Last Name

Street Address

City

State/Province

Zip/Postal Code

Birthdate - mm/dd/yy

Age

Gender
- Female Male
Phone

Email

Division (Individuals)
- 12 Years & Under 13 to 15 Years 16 to 19 Years 20 to 24 Years 25 to 29 Years 30 to 34 Years 35 to 39 Years 40 to 44 Years 45 to 49 Years 50 to 54 Years 55 to 59 Years 60 to 64 Years 65 to 69 Years 70 Years & Over
T-Shirt Size (included with entry fee)
- Youth XS (2-4) Youth S (6-8) Youth M (10-12) Youth L (14-16) Adult S Adult M Adult L Adult XL Adult XXL (Add $2.00)

Would you like to order a Tech T-shirt instead a cotton shirt for an additional $10?

- No Yes
PAES Student Referral - List Name (if applicable)

Check#

Amount Enclosed

WAIVER MUST BE READ, SIGNED AND MAILED WITH ENTRY
OFFICIAL WAIVER: I know that running/walking a road race is a potentially hazardous activity. I should not enter and run/walk unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run/walk. I assume all risks associated with participating in this event including, but not limited to falls, contact with other participants, the effects of weather, including high humidity, traffic and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of acceptance of my entry, I for myself and anyone entitled to act on my behalf, waive and release AA Sports, Ltd., City of Portland, and any and all persons, sponsors and entities, their representatives and successors from all claims or liabilities of any kind arising out of my participation even though said liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission for all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. Parents must sign if participant is under 18 years of age. This is to certify that my child has permission to complete in this event, is in good physical condition and that event officials may authorize necessary emergency treatment. I agree to return the Timing Chip assigned to me or pay a $30.00 replacement fee. ENTRY FEES ARE NON-REFUNDABLE.

Type Full Name


Signature X ___________________________________________________________________
(Signature of Parent or Legal Guardian if participant is under the age of 18)

Date________________________________________