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2018 Prairie Chase Run/Walk Registration

June 23, Orchid Heights Park, Middleton, WI

*Please make sure to enter all required fields.

Event Registration

Thank you for entering this event.

This event will not be cancelled, rescheduled or delayed due to bad weather. There will be no refunds if you do not participate.

Event fees will increase on May 1st to $45 family, $30 individual and $20 student.  And on June 1st to $55, $40 and $25 respectively. Online registration will end at midnight on June 21st.

Registration will be possible on the day of the event at the event registration desk. Day of registration will cost $55 for a family, $40 for an individual and $25 for a student. Only checks and cash can be accepted.

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First Name
Last Name
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T-Shirts

This year's participants will receive a technical t-shirt - breathable, polyester and comfortable! There is a  limit of two t-shirts per family and one t-shirt per individual or student. If you would like to purchase more, please place your order in the section further down on this form.  Additional t-shirts cost $17.95 each.

 

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First Name
Last Name
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Your children's name, age and event.
If you are bringing children to this event and they will participate, Please provide us with their first name, age and select the event they will be in. Children over the age of 12 are not allowed to run in the kids race.









Please provide the name, age and the event for any additional children. The "kids race" is limited to children 12 or younger.
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Please re-enter to confirm
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country

Please tell us how you found out about this event? From a friend? Online? A banner?
This event is a fundraiser for the Friends of Pheasant Branch Conservancy. Your entry fee will be used to help the Friends of Pheasant Branch Conservancy achieve its goal of restoring, protecting and promoting the Pheasant Branch Conservancy and it's watershed. To find out more about us, we encourage you to visit our web site at www.pheasantbranch.org. If you would like to receive a complimentary e-newsletter and occasional announcements please check the box below. (The Friends of Pheasant Branch Conservancy will not share or sell your personal information with any other third party. Your personal email will only be used by us).
Legal Stuff

We're sorry about this, but we need you to read the two release statements below and agree to them before you can participate in our event. If you are 18 years of younger, you will also need one of your parent's or guardian's to agree as well.

Thank you.

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RELEASE, INDEMNIFICATION AND HOLD HARMLESS AGREEMENT In consideration of participating in Prairie Chase Run/Walk, and for other good and valuable consideration, I hereby agree to release and discharge from liability arising from negligence Friends of Pheasant Branch Conservancy and its owners, directors, officers employees, agents, volunteers, participants, and all other persons or entities acting for them (hereinafter collectively referred to as “Releasees”), on behalf of myself and my children, parents, heirs, assigns, personal representative and estate, and also agree as follows: 1. I acknowledge that Prairie Chase Run/Walk involves known and unanticipated risks which could result in physical or emotional injury, paralysis or permanent disability, death, and property damage. Risks include, but are not limited to, bodily harm [actions that might result in injury]; medical conditions resulting from physical activity; and damaged clothing or other property. I understand such risks simply cannot be eliminated, despite the use of safety equipment, without jeopardizing the essential qualities of the activity. 2. I expressly accept and assume all of the risks inherent in this activity or that might have been caused by the negligence of the Releasees. My participation in this activity is purely voluntary and I elect to participate despite the risks. In addition, if at any time I believe that event conditions are unsafe or that I am unable to participate due to physical or medical conditions, then I will immediately discontinue participation. 3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Releasees from any and all claims, demands, or causes of action which are in any way connected with my participation in this activity, or my use of their equipment or facilities, arising from negligence. This release does not apply to claims arising from intentional conduct. Should Releasees or anyone acting on their behalf be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs. 4. I represent that I have adequate insurance to cover any injury or damage I may suffer or cause while participating in this activity, or else I agree to bear the costs of such injury or damage myself. I further represent that I have no medical or physical condition which could interfere with my safety in this activity, or else I am willing to assume – and bear the costs of – all risks that may be created, directly or indirectly, by any such condition. 5. In the event that I file a lawsuit, I agree to do so solely in the state where Releasees’ facility is located, and I further agree that the substantive law of that state shall apply. 6. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect. By signing this document, I agree that if I am hurt or my property is damaged during my participation in this activity, then I may be found by a court of law to have waived my right to maintain a lawsuit against the parties being released on the basis of any claim for negligence. I have had sufficient time to read this entire document and, should I choose to do so, consult with legal counsel prior to signing. Also, I understand that this activity might not be made available to me or that the cost to engage in this activity would be significantly greater if I were to choose not to sign this release, and agree that the opportunity to participate at the stated cost in return for the execution of this release is a reasonable bargain. I have read and understood this document and I agree to be bound by its terms.
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(Must be completed for participants under the age of 18) In consideration of my son/daughter being permitted to participate in this activity, I further agree to indemnify and hold harmless Releasees from any claims alleging negligence which are brought by or on behalf of minor or are in any way connected with such participation by minor.
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First Name
Last Name
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I grant to Friends of Pheasant Branch Conservancy, its representatives and employees the right to take photographs of me and my property in connection with the above-identified subject. I authorize Friends of Pheasant Branch Conservancy, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Friends of Pheasant Branch Conservancy may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.
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First Name
Last Name