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Friday, October 31, 2003
6:30 a.m.
Join us for the 3rd Annual Jim Wahlberg 5K Fun Walk/Run along the beautiful Truckee River. Register for the Fun Walk/Run
before October 30th at the Health and Wellness table in the Exhibit Hall. On the morning of the run, we will gather between
6:15 and 6:30 a.m. at the North Entrance to the Reno Hilton. Once all registrations are gathered and everyone is checked-in,
we will proceed as a group across the Hilton parking lot to the starting point.
All registered participants will receive a Jim Wahlberg 5K Fun Walk/Run t-shirt and refreshments. Proceeds from the race
will go to the Jim Wahlberg scholarship fund.
Registration Fee: $25
Make checks payable to: BPD Wahlberg Scholarship Fund
Name Affiliation
Address
T-Shirt Size: please circle one M L XL XXL
(Extra T-shirts are $20 each. If ordering extra T-shirts, please be sure to note the quantity and sizes desired.)
I would like to make an additional donation in the amount of .
Liability Waiver
I understand that running, jogging, or walking a road race is potentially hazardous activity and that I should not enter
and run/jog/walk unless I am medically able and properly trained. I assume all risks associated with participating in the
event including, but not limited to, falls, contact with other participants, the effects of weather, traffic and road conditions,
all such risks being known and appreciated by me. I agree to abide by any decision of race officials relative to my ability
to safely complete the run/jog/walk. Having read this waiver and knowing these factors, and in consideration of your accepting
my entry, I for myself and anyone entitled to act on my behalf waive, release and indemnify the Baccalaureate Social Work
Education Conference and all of its agents, officers, directors and employees, and any other persons or organizers associated
with this event and their representatives from all claims or liabilities of any kind arising out of my participation in this
event though liability may arise out of negligence or carelessness on the part of the persons named in this waiver. Every
entry must be signed by the runner/jogger/walker or parent or guardian, if the participant is under 18 years of age.
Signature Date
Signature of Parent or Guardian (if under 18 years of age)
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