Surviving The Color Benefitting: Team Of Mercy

Get ready for an explosion of color during the Surviving the Color 5k run/walk! Be sure to dress in white and we’ll make sure you leave covered in color! Saturday May 20th 2017 Packet Pick-up / Race Day registration 7:30 a.m. – 8:45 a.m. @ Meadows Mall Parking Lot by Ohio avenue. 324 South 25TH Street, Terre Haute, Indiana 47803 Race Start 9:00 A.M. @ corner of Brown Ave. and Ohio Ave. Mail in Registration Form Make all checks payable to Crossroads Events (the event organizer) all proceeds will be given to Team of Mercy. Mail all paper registrations to Crossroads Events @ 2508 Cruft Street Terre Haute, IN 47803 _____Pre-Registration ($25) _____Day of Registration ($30) Name:_________________________________ Sex:________ Age:_________ Address:______________________________________City:_______________State:________ Email Address:_______________________________________________________________ Adult Shirt Size: ___Small ___Medium ___Large ___X-Large ___2X-Large ($2.00 extra) Child Shirt Size: ___Small ___Medium ___Large ___X-Large (If you would like you can register to run in memory of an individual or as part of a team) Team Name:_________________________________________________________________ I do hereby relinquish all liability toward Team of Mercy, Crossroads Events, The City of Terre Haute, event sponsors and event volunteers for any damages that may happen to occur during this event. I also understand there are no refunds of fees. Participant Signature: ___________________________________ Date: _________________ If participant is under the age of 18 years old, them must have a parent/guardian signature. Parent/Guardian Signature:________________________________ Date: ________________ As a reminder you must be registered by May 12th to guarantee a t-shirt!