PROCEEDS RAISED BENEFITThe Deb Olsen Scholarship Fund

The Deb Olsen Scholarship Fund was established as a lasting memory of Deb Olsen who passed away in June 2011 from ovarian cancer. Deb was born and raised in Evansville and spent more than 25 years as the Business Manager for the Evansville School District. She gave generously of her time and talent to the community but anyone who knew her well knew Deb’s real passion was

for running and staying fit! Thank you for helping Deb to keep on giving well into the future by supporting this worthwhile cause.

Evansville Soccer ClubThe Evansville Soccer Club provides an opportunity for the personal development of our members through the game of soccer. Proceeds from the 4th of July Run/Walk provides scholarships to help with registration costs so that all kids can have the opportunity to play soccer, for player development, and for graduating EHS Seniors who go on to college. Visit us at evansvillesoccer.org.

Juvenile Diabetes Research Foundation

JDRF is the leading global organization funding type 1 diabetes (T1D) research. JDRF’s goal is to progressively remove the impact of T1D from people’s lives until we achieve a world without T1D. For more information, please visit www.jdrf.org.

PARTNERSHIP The Evansville 4th of July Run/Walk is a partner of the Evansville Community Partnership. The Evansville Community Partnership’s mission is to give all members of the community an opportunity to participate in the cooperative creation of an economically and socially sound, vibrant future for our community and its people. ECP is proud to organize the 2016 Lake Leota 4th of July celebration July 3-7, 2016 with the parade at 10am on July 4th. For complete details see Evansville-wi.net or call 608-882-0598.

Monday, July 4th, 2016Lake Leota Park

Evansville, Wisconsin

7:30am 10K • 5K Run - Walk7:35am 1 Mile Run - Walk

Benefits:Evansville Soccer Club

The Deb Olsen Scholarship FundJuvenile Diabetes Research Foundation

PROUD SPONSORS

Larson AcresBMO Harris Bank

Creekside Place Inc.The Evansville Review

Evansville Veterinary ServiceEvansville Community PartnershipAmerican Transmission Company

Thysse PrintingAllen Realty

Wilke ChiropracticAll-N-One

Good Grief PrintingData Farm Consulting

Piggly WigglyAce Hardware

Petterson PlumbingWisco Disco Mobile DJ’s

Nelson-Young Lumber Co.Hagen Insurance Agency, Inc.

AdvoCare Int. – Jim, Karen, Trevor TwayThe Grove Family Dental and TMJ Clinic

Shannon Law OfficeUrban Exchange

Ward-Hurtley Funeral HomeAmerican Family Insurance

Double D BuildersWeiss Realty

SubwayNight Owl Food & Spirits

Tipi Produce, CSARadio Shack/US Cellular

Blu’s Froyo ShoppeGolz Electric

RACE INFORMATIONMonday, July 4th, 2016 • Rain or Shine!7:30am 5K & 10K start7:35am 1 mile startCertified 5K / 10K CourseFor course maps, go to evansvillesoccer.org

RACE FEES & REGISTRATION: Pre-register by 6/22/16 $25 adult $12 12 yrs & under

After 6/22/16 $30 adult $15 12 yrs & under

Race shirts & timing chips guaranteed to all those pre-registered by 6/22/16. The walk is a non-competitive event and there will be no chip timing. Mail in and online registration closes on 6/29/16. Day of registration 6:15 - 7:00am at Lake Leota Park. No refunds or transfers.

PACKET PICK UP: Friday, July 1st 4:00-6:00pm and Sunday, July 3rd 4:00-7:00pm at Creekside Place Inc., 102 Maple Street, Evansville, Wisconsin

Day of race at 6:15-7:00am at Lake Leota Park by the Army Tank

AWARDS Overall Male / Female Winner - 10K & 5K A unique piece of pottery by local award winning artist Matthias James www.allencreekgallery.comAge Group Winners - Male/Female - 10K & 5K12 & Under / 13-19 / 20-29 / 30-39 / 40-49 / 50-59 / 60+Age Group Winners - Male/Female - 1 Mile Run8 & Under / 9-10 / 11-12All youth 12 yrs. & under receive a medal

SHIRTS & TIMING CHIP Moisture wicking high-performance running shirts. Chip timing for 10K Run / 5K Run / 1 Mile Run only.Must pre-register by 6/22/16 to be guaranteed a race shirt & timing chip.

VOLUNTEERS: Volunteers needed! All volunteers receive a shirt. If interested, email us at: evansvillerunwalk@gmail.com.

Registration FormOr Register Online at RunSignUp.comOne form per person • No refunds or transfers

Name: (First)____________________________ (Last) ___________________________________________

Address: ________________________________________________________________________________

City:_______________________________________ State:____________ Zip: _______________________

Email:_________________________________ Phone: __________________________________________

Day of race Emergency Contact:_____________________________Phone: ______________________

Run ❑ 10K Run ❑ 5K Run ❑ 1 Mile Run Walk ❑ 5K Walk (untimed) ❑ 1 mile walk (untimed)

DOB:____________ Age (as of 7/4/2016):____________ Gender (circle): M F

Shirt Size (circle one): Men S M L XL XXL Women’s Cut S M L XL Youth S M L

Moisture wicking high-performance running shirt. Must pre-register by 6/22/16 to be guaranteed a race shirt and timing chip.

Pre-register by 6/22/16: $25 Adult $12 12 yrs & under $_________.00After 6/22/16: $30 Adult $15 12 yrs & under $_________.00Additonal Donation to Evansville Soccer Club $_________.00Additional Donation to The Deb Olsen Scholarship Fund $_________.00Additional Donation to JDRF $_________.00 Total Race Fee $_________.00

Mail & Make checks payable to: ECP, P.O. Box 321, Evansville, WI, 53536 or register online at RunSignup.com Mail in and online registrations close Monday, 6/29/15.Registrations can be dropped off at Jeff Farnsworth - State Farm, 7 East Main St., Evansville.Waiver: I know that running and walking in a road race is a potentially hazardous activity. I should not enter unless I am medically able and properly trained. I verify to you that I am physically fit and sufficiently trained to participate. I also know that while participating that roads/streets will not be closed to traffic and there may be traffic on the course. I assume all risks associated with my voluntary participation in this event, including, but not limited to, falls, contact with other participants, the effects of weather (including extreme heat, extreme cold, snow and ice), traffic and the conditions on the road with all such risks being known and appreciated by me. Knowing these facts, and in consideration of my accepted entry, I for myself, my heirs, executors, administrators or anyone else who might claim on my behalf, hereby voluntarily release, discharge, waive and relinquish and all claims, complaints, actions or causes of action (“claims”) against Evansville 4th of July Run-Walk, Evansville Soccer Club, The Deb Olsen Scholarship Fund, JDRF, affiliated and successor companies, each of their representatives and assigns (collectively, the “Released Parties”), including but not limited to those (“Losses”) arising from or resulting in any manner from my participation in this event. I agree to defend, indemnify and hold harmless the Released Parties in the event of any and all Claims, by whomever or whatever asserted, including but not limited to such Claims for personal injury, property damage or wrongful death, resulting in any manner from my participation in this event, including without limitation, and to the maximum extent permitted by law, those Losses arising from the Released Parties’ own negligence.

I further grant full permission to the event coordinators, volunteers, and/or agents authorized by them, all rights to use and authorize others to use my name, likeness, picture, voice, city and state of residence, biographical materials and any materials submitted in connection with this event (“image, information, and materials”) for marketing and advertising purposes (but not for any use constituting a direct endorsement by me of any product or service), in any media, worldwide, in perpetuity, and without need for compensation or royalty of any kind. I understand that the parties are not obligated to use an image, information and materials, but may do so and may edit my image and materials, at the individual party’s sole discretion without further obligation or compensation to me.

I consent to emergency medical care and transportation in order to obtain treatment in the event of injury to me as medical professional may deem appropriate and agree that Waiver and Release extends to any such medical care, treatment and transportation. I further acknowledge that I will be responsible for the cost associated with such medical care, treatment and transportation.

I understand that my entry is non-refundable and non-transferable.

Print:___________________________ Signature:________________________ Date: _________________________ (parent signature if under 18 years)

For more information go to evansvillesoccer.org or contact evansvillerunwalk@gmail.com Like us on facebook at Evansville 4th of July Run-Walk.

No refunds or transfers. Reassignment or selling of registration is not permitted.