Mayo Clinic Corporate Challenge Entry Form

Instructions to enter:

Print this form (using your browser's Print button); complete form (print legibly); enclose the appropriate entry fee (checks payable to Mayo Corporate Challenge); mail to or drop off at:
Mayo Clinic Corporate Challenge
c/o Runner's Den
6505 N. 16th Street
Phoenix, AZ  85016


Event: 8K Run[ ] 5K Walk[ ] 1 Mile Fun Run[ ] 8K Skate[ ] Aerobic Jam[ ]
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Last Name
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First Name
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Mailing Address - Include Apt. No. and/or C/O
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City                                           State    ZIP Code
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Day Phone                           Birthday (mmddyy)      Sex     Age     T-shirt
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Fax                                 Amount Enclosed

I am participating as a member of a Team (select one below): Corporate[ ] School[ ] Open[ ]

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I am the CEO of a company with 50 or more employees.[ ]
Waiver (please read and sign): In consideration of your acceptance of this entry, I hereby, for myself, my heirs, my executors, and administrators, hereby waive any and all rights and claims for damages I may have against the sponsors, coordinating groups, and any individuals associates with the event, their representatives, successors, and assigns, and will hold them harmless for any injuries suffered in connections with said event. Also, none of the above are responsible for the loss of personal items nor any other form of aggravation in connection with said event. I have been warned I must be in good health and prepared to participate in this extremely physically demanding event. In filling out this form, I acknowledge I have read and fully understand my own liability and do accept the restrictions.

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Entrant's Signature (Parent's if entrant is under 18)