Race Sponsors 24th Annual Fall 15K and 3X5K Relay Race Proceeds Majority of the race proceeds benefit the Juvenile Diabetes Research Foundation Sunday October 22, 2017 9:00 am JDRF is the leading global organization funding type 1 diabetes (T1D) research. Our strength lies in our exclusive focus and singular influence on the worldwide effort to end T1D. Vision: A world without type 1 diabetes Mission: Accelerating life-changing breakthroughs to cure, prevent and treat T1D and its complications Type 1 diabetes is an autoimmune disease that strikes both children and adults suddenly. It has nothing to do with diet or lifestyle. There is nothing you can do to prevent it. And, at present, there is no cure. JDRF works every day to change the reality of this disease for millions of people—and to prevent anyone else from ever knowing it—by funding research, advocating for government support of research and new therapies, ensuring new therapies come to market and connecting and engaging the T1D community. Proceeds Benefiting the Juvenile Diabetes Research Foundation Hosted by If you wish to make an additional contribution to JDRF, you may do so at the race site or please write one check which includes race entry fee and your additional donation.  Please make note in the memo line regarding the additional donation. . . The only 15K in Madison

Fall 15K & 3X5K Relay Registration Form Date, Time, and Place Sunday, October 22, 2017 Start Time 9 a.m. Warner Park, Madison, WI Fall 15K & 3X5K Relay Registration Form Pre-registration is $15/person and $45/relay team, postmarked by 10/16/17. Late or day of registration is $20/person and $60/relay team. Competitions Men’s and Women’s 15K run Men’s, Women’s & Coed 3X5K relay Send completed registration and check payable to: Running Club @ UW-Madison 2000 Observatory Drive, Room 1180 Madison, WI 53706 Registration Pre-registration: $15 per person, $45 per relay team (must be postmarked by 10/16/17) Late or day of registration: $20 per person, $60 per relay team Online Registration available at www.athenstoatlantis.com (maximum processing fee $1.02) Entry fee includes winter hat, race number, food, beverage and raffle prizes. Packet pick-up: Oct 21th at the Movin’ Shoes Store in Madison 1:00pm - 5:00pm OR day of race at the Warner Park Shelter 7:30 -8:45am Name: Last First Age: Sex (circle): Male Female Address: City: State: Zip: Phone: Email address: (for announcement of running club races) Relay teams are encouraged to provide their own transportation to the relay exchange zone (same drop off area for 5K and 10K exchange). However, transportation can be provided to relay exchange zone and to the finish line for relay participants. If you wish to be part of relay and are looking for relay team members, contact Ron Carda at carda@education.wisc.edu or 608-262-3369 and we will assist in helping find relay teammates as best as we can. Relay Information Circle one: 15K run 3X5K relay RELAYS: The relay race consists of a three (3) member team, with each member running a 5K leg. Team Name: Team Type (circle): Male Female Coed Names of other relay team members Each member of relay team needs to fill out a registration form. Please consider mailing all forms/entry fees in a single envelope. The race starts and ends in Warner Park. The course includes some rolling hills. Walkers, baby strollers, and baby joggers are welcome. No pets, roller/inline skates allowed. Course closes at 11am. Quick Course Facts Waiver – I understand that running is a potentially hazardous activity.  I shouldn’t enter unless I’m medically able and properly trained.  I assume all risks associated with running in this event.  Having read this waiver and accepting my entry, I, for myself or anyone entitled to act on my behalf, waive and release the Board of Regents of the University of Wisconsin System, its officers, employees and agents, the Running Club at UW-Madison, the City of Madison, and Dane County, WI from all claims or liabilities of any kind arising out of my participation in this event.  I understand that the University has no medical coverage and that any medical expenses I incur are my responsibility.  I have read this waiver and understand it.  I understand that participation is voluntary and I freely choose to participate. For More Information: www.runningclubuw.com Race Proceeds Signature: Date: Majority of the race proceeds benefit the Juvenile Diabetes Research Foundation If under 18, a parent or guardian signature is necessary.