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5th Annual Wolf 5K and Fun Run Registration
Please fill out this form for each race participant.

Race Date: December 9th, 2017

Location: Mason Creek Middle School
7777 Mason Creek Rd.
Winston, GA 30187

Race fee: Bring a Toy for Toys for Tots in Memory of Herb Emory

Race Day Registration and Packet Pick up 6:30-7:45 AM
5 K 8:00 AM
Fun Run 8:45 AM

T shirts: If you would like to purchase a t-shirt, send in $15.00 (if 2XL add $2.00) by check or money order to Mason Creek Middle School, 7777 Mason Creek Rd., Winston, GA 30187, (ATTN: Judy Cross) by November 17th to receive your shirt by race day. All orders placed after November 17th may be picked up at the school or will be sent to their school within Douglas County School system.

All Race Proceeds Benefit Toys for Tots

Which race are you signing up for?
Choices: 5K, 1 mile Fun Run, Both
Last Name *
ex. Smith
Your answer
First Name *
ex. Jane
Your answer
Email Address *
Your answer
Street Address *
ex. 123 Main St.
Your answer
City *
Your answer
State *
Your answer
Zip code *
Your answer
Phone number *
Your answer
Participant's age as of December 9, 2017 *
Your answer
Gender *
School or Roadrunner club that you are representing (if applicable)
Your answer
For Mason Creek Middle School students: Who is your homeroom teacher?
Your answer
Read Information below for agreement and type signature.
Waiver: In consideration and acceptance of this entry form for Mason Creek Middle School Wolf 5k and Fun Run, I hereby waive any and all claims for my heirs and myself and assigns against the sponsors and officials of the event for injury or illness, which may result from the participation of my child. I also give permission for the use of my child’s name and photograph in any media or accounts of this race.
Participant's signature *
type in your first and last name
Your answer
Date *
Your answer
Signature of legal guardian (if participant is under 18 years of age) *
Your answer
Date *
Your answer
T shirt size (check ONLY if you are purchasing a shirt) Tshirts are $15 and may be pre-ordered by November 19th to receive on race date. Send Check or money order to Mason Creek MS, ATTN. Judy Cross
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