Entry Form

Sat. April 2, 2011

  • 5K Vergas Maple Syrup Run
  • Sign-up 8am @ Billy’s Corner Bar, Vergas, MN
  • Start Time: 9am
  • Registration Fee: $20
  • Includes: Maple Syrup Fest
  • Breakfast & Maple Syrup Fest 5K Stocking Cap
  • Race Begins & Ends in front of Billy’s Corner Bar
  • Medals will be awarded to Top 3 Finishers of each age group.

 
Mail Entry Form & Entry Fee:

VMS: PO Box 264
Vergas, MN 56587
Checks made payable to Vergas Community Club

Age Categories: Male & Female

15-19 yrs 20-29 yrs30-39yrs 40-49 yrs
50-59 yrs 60-69 yrs 70 plus
Course: Is out & back all asphalt.
Waiver: I hereby enter the Vergas Maple Syrup 5K Run. I enter at my own risk and personally assume any risk or responsibility for injuries incurred as a direct or indirect result of my participation in this event. I further agree to not hold the Vergas Community Club or race directors or any party associate with this race responsible.

 
Name: ____________________________  
Street Address _____________________ City/State________________________________
Phone _____________________________ Email ___________________________________
Sex M/F DOB _______________________ Age on Race Day__________________________
Signature __________________________ Signature of Guardian if under 18 years of age______________________________________

Mail Entry Form & Entry Fee:

VMS: PO BOX 264
Vergas, MN 56587

Checks made payable to:

Vergas Community Club

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Good Luck!

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