Sponsors:A special thank you to our event sponsors who make the Boys & Girls Clubs 5K for Kids possible. Please support our local businesses!

OF WASHINGTON COUNTYwcbgc.org

New Location!Starting Line at West Bend Mutual Insurance CampusFinish Line Party Included!

The Boys & Girls Clubs of Washington County are dedicated to promoting character building experiences through social, educational and recreational activities. More than 2,500 Washington County children participate in activities at the Club’s five locations. Please call or see our website for all the programs we offer. Boys and girls ages 6-17 are welcome to join the club. Minimum annual contribution is $65. HARTFORD: 755 S. Rural StreetJACKSON: N165 W20330 Hickory LaneKEWASKUM: 1415 Bilgo LaneWEST BEND: 925 N. Silverbrook Drive

REGISTRATION FORM 2019 5K For Kids

(one form per person/team)

Check One: o5K Runner

o5K Walker

oKids Race age 6 or under

oKids Race age 7-9

Male: ___ Female:___ Age on June 2, 2019 ____

Name (Team Captain): ___________________________

Team Name: _________________________________School Attending (K-12): _________________________Email: ______________________________________Phone: ______________________________________Address: ____________________________________City: ____________________State:____Zip:_______

Check shirt size: (Guaranteed if registered by 5/17/19)Adult: Sm-o, Med-o, Lg-o, XL-o, XXL-oYouth: Med-o, Lg-oKnowingly and at my own risk, I hereby apply to enter the Boys & Girls 5K For Kids Walk/Run and do hereby waive and release Washington County Boys & Girls Club, West Bend Mutual Insurance Company and the City of West Bend, all representatives, all sponsors, all volunteers, all race directors/staff, their subsidiaries, heirs and successors, agents and attorneys, from any and all claims of liabilities of any kind and character whatsoever arising from my participation in the Walk/Run or my transportation to/from the Walk/Run. I consent to the full use of my image in photos and videos for any legitimate purpose as regards the recording or future promotion of this event. I consent to the release of my event registration information to outside organizations. I am physically fit and sufficiently aware of the risks involved in participation in walk/run events of this kind/distance and in any outdoor activity with regards to weather, automobile traffic, pedestrian traffic, etc. I am aware that this event course is open to vehicular traffic during the event. I accept any and all additional risks posed by the use of strollers/wagons during this event.

Please make checks payable to Boys & Girls Clubs of Wash. County and mail to: 925 N. Silverbrook Dr., West Bend,WI 53090. Payment must be received by May 17, 2019 to guarantee t-shirt.If you care to make a personal pledge to support the initiatives of the Boys & Girls Clubs of Washington County (optional) : o$10 o$25 o$50 oOther and/or o$20 to sponsor a child.

Reg. Fee: $________ Sponsor a Child: $_______ Pledges: $________ Total Paid: $_______Date:_________________Signature of applicant:__________________________ (Parent if under 18): ___________________________

Entry Fees:5K Individual $25 (Same Day - $30) 5K Team $20/person ($5 discount, pre-registration only)

Kid’s race $10 (9 or under)

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Sponsored By

The information provided is not sponsored or endorsed by the

West Bend School District or its personnel.

All Locations262.334.3732

Run / Walk for Adults & Kids

AVAILABLE

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OF WASHINGTON COUNTYwcbgc.orgHartford • Jackson • Kewaskum • West Bend

Benefitting

SUNDAYJune 2, 2019

NEWLocation

for2019

Register: 8:30am • Race: 10am

KILIANMANAGEMENT SERVICES

Badger PromotionsBMO Harris Financial AdvisorsDaily News Gruber Tool & Die, Inc.Kewaskum Family Dentistry Kewaskum StatesmanKey Technical Solutions

Kieckhafer, Dietzler, Hauser, Hanson Mantz AutomationMiller MonumentMr. Tony’s BBQNational Exchange BankR&R InsuranceRichards Insurance Agency

Better BrandsDISTRIBUTING1

wcbgc.org • active.com

The Silver Lining5K Run/Walk For KidsA 3.1 mile run/walk at the West Bend Mutual Insurance Campus. Open to runners and walkers at all levels, children and adults of all ages. Strollers are permitted on the run/walk course. Plus special children’s races for ages 9 and under offered! All proceeds support the Washington County Boys & Girls Clubs, with locations in Hartford, Jackson, Kewaskum and West Bend.

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CHIPTIMING

When Sunday June 2, 2019 (Rain or Shine) 8:30am Registration 9:30am Kids Races - 1/2 mile: ages 7-9, 1/4 mile: ages 6 and under (with or without parents) 10:00am 5K Run/Walk Start Race results at pttiming.com.

Where (New Location for 2019)Register and start at West Bend Mutual Insurance Campus - 1900 S. 18th Ave., West Bend, WI. Part of the race will be on gravel trails. No dogs allowed. Directions: Exit Hwy. 45 at W. Paradise Drive, turn west off the ramp. Turn left at S. 18th Ave. and then right at the entrance to WBMI. Parking is available.

Sponsor a ChildThe Boys & Girls Club offers “Sponsor a Child”. For $20.00 you can sponsor a Boys & Girls Club member who otherwise may not have been able to participate in the 5K. We would like to see as many Boys & Girls Club members and their families participate as possible. Thank you for giving them this opportunity!

PrizesAll finishers in the children’s races will receive awards. Awards to the top male and female 5K finishers overall. The top 3 male and female 5K finishers in the following age groups will also receive awards: 9 and under, 10-11, 12-13, 14-19, 20-29, 30-39, 40-49, 50-59 and 60-69, 70 and over.

Registration and T-shirtsPlease complete attached form and drop off or mail with entry fee to Boys & Girls Club, Attn: 5K for Kids, 925 N. Silverbrook Drive, West Bend, WI 53090. Please make checks payable to Washington County Boys & Girls Club. Registration is also available online at active.com or a printable registration form is available at wcbgc.org.

Entry Fees: 5K Individual - $25 (Same day - $30) 5K Team - $20/person (Pre-registration only) Kid’s race - $10 (Age 9 and under)

Entries received by May 17, 2019 are guaranteed a t-shirt. Same day registration is also available, however t-shirts for entries received after May 17 are not guaranteed.

Additional registration forms are available at all Washington County Boys & Girls Clubs locations, the Jackson Community Center, and on line at wcbgc.org.

Pre-registered participants may pick up race packets and t-shirts at the B&GC of West Bend May 30 from 10am-2pm and 5-7pm or on the day of the event beginning at 8:30am.

Maps of the course will be provided. Same day registration will open at 8:30am June 2 at the West Bend Mutual Insurance Campus. Race results can be found at pttiming.com.

All proceeds benefit the Boys & Girls Club of Washington County and the Boys & Girls Clubs of

Washington County Scholarship.

OF WASHINGTON COUNTYwcbgc.org

TeamForm

RegistrationTeam Registration is $20/person(A $5 discount per person)

No teams will be allowed to register day of the race – Pre-registration onlyTeams can be made up of corporate groups, family, friends, school groups, running clubs, etc. Teams must have a minimum of 10 participants at the Adult Race price

All registrations and payment must be received at the same timeTeam captains fill out the registration form on the reverse side and attach a list of all team mates with the following information for each member:

Male: ___ Female:___ Age on June 2, 2019____

Name (Team Captain): _______________________School Attending (K-12): _____________________Email: __________________________________Phone: __________________________________Address: ________________________________City: _________________State:____Zip:_______

New Location for 2019

Finish Line PartyThe Finish Line Party is a post Run/Walk celebration for all participants to enjoy. Participants only are welcome to stay and enjoy refreshments, live entertainment and much more! See the wcbgc.org website for band announcement.