runflyer2013 (PDF)

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Teal Lotus Run into the Stadium D
5K Run/ 2 Mile Walk

Saturday, April 27, 2013 @ 4:00 pm

Run begins and ends at the Haymaker Stadium
1710 Meridian Ave in Cozad

“The Teal Lotus Project is an organization focused on sexual
assault awareness and prevention. Helping survivors find
their path”

Entry Fees:

Early Bird (before April 11th):
Run $15
Day of race
Package $20
registration will
After April 11th:
Run $20
Package $25

“D.C. Hunt is an Omaha based musician looking to tell a
story of hope and redemption through music.”

be at 2:453:45p.m. at the

Runners and walkers of all
ages and fitness levels are
encouraged to participate.
This is a non-competitive
event. Please join us for a
memorable concert following
the run. Door prizes will be
given and merchandise will
be available.

Concert only registrations, $10
regardless (t-shirt not included)
6 yr. old & under enter concert for FREE

Family Fees: (through April 11th)

Immediate family only, please

$40 for 3 people
$50 for 4 people
$8 for each additional family
o $5 additionally for each
individual to receive the
concert package

All run proceeds go to The Teal Lotus Project.

If rain occurs, concert will be
held in the High School
T-shirts guaranteed for all
run/walk participants who
preregister by April 11th .

If you are a Survivor, please email
for a special (confidential) recognition
at the run.

----------------------------------------------------------------------------------------------------------------------------------------------------------------------------Name _________________________________________________
Address _______________________________________________
Phone Number _________________________________________
Please make checks payable to:
The Teal Lotus Project.
Drop off forms at State Farm Insurance or mail to Stacy
Evertson, 502 W 10 Cozad NE 69130

E-mail _________________________________________________
Emergency Contact ______________________________________
Event: 2-mile walk ___ 5K ___ Concert ___ Package ___
t-shirt not included

Race day age: _____

T-shirt size: (Youth)
Waiver: I know that running in a race is a potentially hazardous activity.
I hereby waive and release all rights and claims for damages I may have (Adult)

M/F (Circle one)
S / M / L (Circle one)
S / M / L / XL / XXL (Circle one)

against the organizers and sponsors of the Teal Lotus Run for any and all
injuries suffered by me or my family in this event. I further certify that I am in good enough health to participate in this event.

Signature: ______________________________________ Date: ____________________________

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