All proceeds will go to the Eastern Alumni Scholarship Fund

November 9-15, 2020

COST

• Registration: $30

A PACE Registered Event

Hosted by Eastern Oklahoma State College Alumni Association

Wilburton, OK

RUN Information

• The virtual format allows participants to run/walk anytime and
  anyplace between Monday, November 9, 2020, and Sunday, November 15, 2020.

  
  

• You must complete the Virtual run between November 9th – November 15th.

  
  

• The registration form must be returned to EOSC or PACE (once completed) by November 20th.

  
  

Distance of Run (e.g. 1 Mile)    Date of Run 
Duration of Run    Location of Run 

Shirts and Finisher awards will be available to pick up at designated areas.

Dates for pick up to be scheduled at a future date.

Please choose one:

Mountaineer 5K Registration

You may pay your registration online using the submit button at the bottom of the page

You may also print and mail this form using the print button.

NON-PACE Runners:

Once you complete your distance, date, finish time, and location,
mail registration to:

Mail registration form to:

EOSC Alumni Association – Mountaineer 5K

1301 W Main Street

Wilburton, OK 74578

For more information, contact:

Teresa Brady

phone: 918.465.1761

email: tbrady@eosc.edu

First Name:    Last Name:

Mailing Address:

City:   State:   Zip:

Phone:   E-Mail:

Gender: Female  Male           Age (as of Nov. 9, 2020):

T-Shirt Size:

Adult




S	M
L	XL
2XL	3XL





Youth




S	M
L	XL




Select one: 5K    1 Mile Fun Run

(if under 18, form must also be printed and signed by parent or guardian)

Waiver of Liability : I know that the event is held on a road that is traveled on by vehicles and may be hazardous. I assume the risk and responsibility for my safety.
I hereby waive all claims that I or my estate may have against any persons of entities involved in organizing, conducting, or supporting this event for any injury of loss I might suffer even if injury of loss was caused by the negligence of those parties.
I attest that I am physically fit and prepared for this event. I grant full permission for organizers to use photographs of me or my child. Parent/Guardian Signature required if under the age of 18.

I have read, and understand, the Waiver of Liability

I have not read, or I do not understand, the Waiver of Liability