COMPACFLT OFFICER SPOUSES’ CLUB

KIZUNA
(BONDS OF FRIENDSHIP)

5K FUN RUN/WALK
JAPAN EARTHQUAKE/ PACIFIC TSUNAMI RELIEF
DATE: Saturday, May 21, 2011, 7:00 a.m. sharp

COURSE: Ford Island. Flat 5K run around the Ford Island Runway. The start will be just west of the Pacific Aviation Museum parking lot
adjacent to the runway in the middle of Ford Island. The start and finish will be at the same point after completing two laps around the runway. The course will
keep all runners on the right side of the roadway within the bike path. Orange cones will clearly designate the course, with NO CHIP-TIMING.

PROCEEDS GO TO: American Red Cross Japan Relief. This 5K Relief Run is to support Japan by raising funds for the devastated by the Earthquake
and Tsunami in Northern Japan this past March.

REGISTRATION: The official signup for the 5K ends Monday, May 16, 2011 at 1200. If you plan to register the morning of the race, please show
up around 0620 to sign up.

ELIGIBILITY: Active duty, Reserve, Retired personnel, DoD employees and their families. Runners, walkers and strollers (strollers will line up
at the back of the pack). NO PETS.

ENTRY FEE: $15

PACKET PICK UP: Runners HI, FRIDAY, May 20, 2011 from 10 a.m. to 2 p.m.

SPONSORS: DumBell Fitness; Dr. Neil Furuya, DDS, Honolulu Peridontics; Hair Attitudes; Hakubundo, Inc.; Kiewit; Pacific Aviation Museum;
Runners HI

--------------------------------------------------------------------------------------------------------------------------------------------------------
PARTICIPANT INFORMATION

Last Name____________________________________________________First Name_________________________________

Address________________________________________________________________________________________________

City___________________________________________________________Zip Code ________________________________

Phone ____________________________________________ Ext.____________ Age on Race Day_____________________

E:mail Address__________________________________________________________________________________________

Entry Fee. Please check the appropriate box(s):

□ $15.00 Entry Fee
□ $ _____________ Tax Deductible Donation. I would like to help those affected by disasters like the Japan
Earthquake and Pacific Tsunami as well as countless crises at home and round the world, by making a donation
to support American Red Cross Disaster Relief. Your gift enables the Red Cross to prepare for and provide
shelter, food, emotional support and other assistance in response to disasters.
Total Amount Enclosed: ________________. Make checks payable to AMERICAN RED CROSS

MAIL TO: KIZUNA 5K FUN RUN/WALK, c/o 752 MCGREW POINT, AIEA HI 96701

ALL PARTICIPANTS MUST READ AND SIGN THIS WAIVER: I acknowledge that this event is an extreme test of a person’s physical and mental limits and carries with it the
potential for death and property loss. I hereby assume the risks of participating in this event and certify that I am physically fit, have sufficiently trained for participation in this
event and have not been advised otherwise by a qualified medical person. I hereby take action for myself, my executors, administrators, heirs, next of kin and successors, and
assigns as follows: a) WAIVE, RELEASE, AND AGREE NOT TO SUE, from any and all liability for my death, disability, personal injury, property damage, property theft, or
action of any kind which may hereafter accure to me as a result of any participation in or my traveling to and from this event, THE FOLLOWING PERSONS OR ENTITIES:
Event sponsors, race directors, representatives, agents and volunteers; b) INDEMNIFY AND HOLD HARMLESS the persons or entities mentioned in this paragraph from any
and all liabilities or claims made by other individual or entities as a result of any of my actions during this event. I HEREBY CERTIFY THAT I AM 18 (EIGHTEEN) YEARS OF
AGE OR OLDER. I HAVE READ THIS DOCUMENT AND I UNDERTAND ITS CONTENTS.

All participants must sign here: _________________________________________________________Date: ________________________

The American Red Cross name is used with its permission, which in no way constitutes an endorsement, express or implied, of any product, service, company, individual or political position. For
more information about the American Red Cross, please call 1-800 HELP NOW or email <mailto:info@usa.redcross.org> info@usa.redcross.org.