Pre-Register = $10 Race Day = $15 Pre-Registration Deadline is November 3oth!

Submit entries and checks made out to Arctic Warrior Challenge c/o Kyle Putnam 1346 Meadow Lane Morganton, NC, 28655 All proceeds will go to the Optimist Club of Morganton. Funds will be used for childhood cancer research and community projects. Canned food donations will also be accepted. Canned food will be donated to B.U.C.M. December 10th, 2011

The Arctic Warrior Challenge

A 5K and 1 Mile Fun Run Race for Charity December 10th, 2011 Morganton, NC Catawba Meadows 9:00 a.m.

Application for ARCTIC WARRIOR CHALLENGE

Suspendisse Address:___________________________________________ potenti. City:_______________________________________________

Name:_____________________________________________ State:___________ZIP:_______________________________ Email Address:_____________________________________ Male:_____ Female:_____ Age on Race Day:__________ DOB: _____/_____/_____ Emergency Contact Name:____________________________________________ Phone Number:_____________________________________ Register for ________Fun Run ________ 5K Shirt Size (circle one)

Race Location: Catawba Meadows: 701 Sanford Drive Exit I-40 at #103 (Morganton/Rutherfordton) go 0.2 miles to end of ramp. Turn Right on Burkemont Avenue (US-64) - go 0.7 miles (beside stop light at NCSD football field). Turn Left on W Fleming Drive (US-70) - go 1.1 miles.

Generous Sponsorship Provided by:

Adult:

S M L XL

Waiver: Must be filled out and signed completely. In consideration of acceptance of this entry, I waive all claims for myself, my heirs, executors, administrators and assigns against sponsors, organizers, officials and any other persons, or organizations directly or indirectly connected with the ARCTIC WARRIOR CHALLENGE run from any and all claims for personal injuries and or property damages resulting from participation in this event. I realize that this is a strenuous event requiring proper physical conditioning and state that I have trained for this event and I am in proper physical condition for this event. I understand and agree that photographs, films, television, or radio interviews from the event may be taken and released to the public without any compensation being paid to me, the undersigned. I hereby represent that I am 18 years or older, or that the person signing as parent/guardian for permission allowing the entrant to participate is the actual parent or guardian. This is a release. Read carefully before signing.

Continue straight onto Sanford Drive (US-64-BYP) go 1.9 miles to park entrance on the Left (Catawba Meadows Blvd).
Prizes are available to: Top 3 Male Overall

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Applicants Signature
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Top 3 Female Overall 1st Place Male Masters 1st Place Female Masters Fun Run Participants

Parent/Guardians Signature (18 & Under)

Date: ____/____/____