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Wooly Worm 5K - Saturday, October 6, 2012
Camargo, Illinois - 7:30 a.m.

If you would prefer to mail your entry, click here to download a form.

 
2012 Wooly Worm 5K Registration Form

Name *
First *
Last *
Address *
Street Address *
Address Line 2
City *
State / Province / Region *
Postal / Zip Code *
Country *
Phone *

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Email *
Age (on 10/6/12) *
Please enter the age you will be on race day.
Gender *
 Male 
 Female 
Shirt Size
 Youth Small 
 Youth Medium 
 Youth Large 
 Adult Small 
 Adult Medium 
 Adult Large 
 Adult XL 
 Adult 2X 
 Adult 3X 
Shirts are guaranteed only for participants whose entry forms have been received by September 28, 2012.
Event *
 5K Run 
 5K Walk 
 Family Fun Run/Walk 
Waiver *
 I agree to these terms. 
Waiver: I know that participating in a road race is a potentially hazardous activity. I should not enter and run or walk unless I am medically able and properly trained to complete the event. I agree to abide by any decision of a race official relative to my ability to safely complete this event. I assume all risks associated with participating in this race, including, but not limited to falls, contact with other participants, runners, bikers, horses and other animals, the effects of weather, including heat or cold and precipitation, traffic, and the conditions of the roads, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I for myself and anyone for whom I am entitled to act, waive, release, and will hold harmless the race organizer, Village of Camargo, Playtime Cooperative Nursery School and staff, all other sponsors and property owners, and all the agents, employees, officers, directors and volunteers working for those entities from all claims and liabilities of any kind arising out of or related to my participation in this race. I understand that roller skates and dogs are not allowed in this race

When finished, click the Submit button, which will direct you to a payment page to complete your registration.
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