“Bog Jog”

10K & 5K RUN / 3K WALK

9:00 AM, Sunday, October 10, 2010, Grayland, WA

Print this form and send it in with the entry fee to:

Cranberry Coast Chamber

PO Box 305

Grayland, WA 98547

Location/Course: The race will start and finish at the Grayland Community Hall, a country block off Hwy 105 at Grange Rd., Grayland. The race is a combination of the spectacular Pacific Ocean beach and flat roads through the Cranberry bogs.

Registration: Registration begins at 7:00 AM at the Grayland Community Hall. Advance entry fee $15 (Day of Race Fee: $20)

Race participant packets with commemorative T-shirts and number can be picked up at the Cranberry Harvest Festival, Grayland Community Hall on Saturday, the day before the race between 2 PM – 4 PM, or on the day of the race, Sunday, starting at 7AM. Proceeds will support the Cranberry Harvest Festival.

Please make checks payable to Cranberry Harvest Festival

P O Box 305

Grayland, WA. 98547

Event T-Shirt (please circle one)

Adult Shirt Size: M L XL 2XL Youth shirt Size: M L

Awards: Trophy for Overall Winner in each Men & Women

Trophy for Top Youth – 18 and under

Trophy for Top Family – At least 3 members, one must be a parent.

Information: Email Jaymie at Jaymie@TheBayGardens.com

(Check one) [ ] 10K Run [ ] 5K Run [ ] 3K Walk

Name: __________________________________________ _______________________________

Last First

Address: ____________________________City: _________________ State: _____ Zip: _________

Phone: (Work) __________________ (Home) ____________________ (E-mail) _________________

Sex: [ ] M [ ] F Age: ____________ Race/Event _____________________________________

Registration and receipt form/waiver for participation: I, the undersigned, being apprised of the conditions of this race, assume all risks incident to my participation in this race. Further, I hereby represent to have adequately trained for this event. I hereby, for myself, my organization, my heirs, executor, and administrators, waive and release any and all rights and claims for damages I may have against the Cranberry Coast Chamber of Commerce, or any organization in whose grounds this activity is being held, and any instructors or persons of these departments, for any and all claims, demands, or injuries received in participating in this race.

Participant’s Signature: ____________________________________ Date: ______________________

Parent/Guardian’s Signature (if under 18) ______________________ Date: _____________________