Winter Sprinter Registration

Winter Sprinter 5K Snowshoe Run/Walk
Saturday, February 27, 2021
Registration Form

$25.00/Participant - Ages 13 - Adult
$15.00/Participant - Ages 3 - 12

NOTE:  Participants renting snowshoes must call to verify snowshoe availability and reserve a check-in time of either 9:00 a.m. or 1:00 p.m.

Print and fill out one registration form per participant - Return to Brillion Nature Center with payment.

Name:  _________________________________________________________________________________

Address:  _________________________________________________________________________________

Phone:  _________________________________________________________________________________

Email: _________________________________________________________________________________

Snowshoe rental not needed: _______

Snowshoe rental needed (check one size below):

Adult ____  Pre-K - Grade 1 Youth ____  Grade 2 - Grade 5 Youth ____ Grade 6 - Grade Youth ____

Shirt Size (circle one):     S       M       L       XL       2X

Mail with payment to:  Brillion Nature Center, 315 S Main St, Brillion, WI  54110
OR
Drop off at our location:  W1135 Deerview Road, Brillion

By registering and participating in this event, I give permission for the event organizers or medical personnel to administer first aid treatment and/or allow a physician or hospital to administer treatment in case of an emergency. I waive and release any and all rights, claims, and causes of action I have or may have against Brillion Nature Center, event organizers and volunteer staff, that may arise as a result of my participation in the event.

Signature:  __________________________________________________________________

Relationship to participant:  _____________________________________________________

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