The Umstead Coalition "Dedicated to the appreciation, use, and preservation of the William B. Umstead State Park and the Richland Creek natural area."   Join Us Membership & Donations Volunteer Merchandise
	Register for The Umstead Coalition email updates About Us Home Contacts History of the Coalition Site Search FAQ Walk/Run/Bike for Umstead News Alerts Newsletter About the Park Park History Stories in Stone Park Ecology Trail Map Getting Involved Outings Streamwatch Park Service Park Information Contacts Mail: The Umstead Coalition; P.O. Box 10654; Raleigh, NC 27605-0654 Voice Mail: (919) 852-2268	2010 Walk/Run/Bike for Umstead Registration Form If your browser doesn't support forms please print this page, fill it out, and mail it to: The Umstead Coalition; P.O. Box 10654; Raleigh, NC 27605-0654 or you may fax it to (919)515-7448 [If the form isn't working, please just copy this page and send it to volunteer at umsteadcoalition dot org in an email message] The Walk/Run/Bike happens rain or shine! April 17, 2010 First Name: Email address: (e.g.: you@aol.com) Last Name Home Phone Age Gender M F Work Phone Street Address City State Zipcode I am entering one of the four events (check only one): Run 4 miles Walk (up to 4 miles) Tour de TORC*: 4-Mile Beginner Guided Bike Ride Tour de TORC*: 12-Mile Intermediate Guided Bike Ride My goal is to raise $ Team Registration (if applicable) Team Name Team Captain T-shirt Size XXL XL L M S Child What do you like most about Umstead State Park? (optional) Parking for Walk/Run/Bike/Live Music: On-site parking before 9:15am - Reedy Creek Rd. Turn off Blue Ridge Rd. opposite the NC Art Museum onto Reedy Creek Road, Raleigh Cars will be allowed to exit and enter again after 9:50am. Registration Fees: Child (age 12 & under day of event): $15 Adult: $25 if registered by April 11; $35 if registering on or after April 12 Spectators and Live Music - FREE Options for paying your registration fee: Click here to use PayPal to make a donation (BUT, you have to return to site & click SEND at bottom for your registration information to reach us!! Mail to: The Umstead Coalition, PO Box 10654, Raleigh, NC 27605 IMPORTANT: PARTICPANTS UNDER AGE 18 MUST ALSO HAVE THIS FORM SIGNED BY A PARENT OR GUARDIAN. Parent or Guardian Date (:mm/dd/yy)   I want more information on Umstead Coalition Activities   I want to join the Umstead Coalition email list WAIVER: I understand that my consent to these provisions is given in consideration of the acceptance of this registration and for being permitted to participate in this event. I am a voluntary participant in this event, and in good physical condition. I know that this event is a potentially hazardous activity and I hereby assume full and complete responsibility for any injury or accident which may occur during my participation in this event or while on the premises of this event. The undersigned hereby knowingly and willingly releases, remises, and forever discharges, and agrees to indemnify, defend, and hold harmless and covenant not to file suit against The Umstead Coalition, its employees, members, officers, directors, coordinators, volunteers, agents, sponsors, local affiliates, affiliated individuals and organizations, and permitted assigns (known collectively, the "Releasees"), for all losses, liabilities (including liability for attorney's fees), claims, damages, and costs (known collectively, "Losses") that may now exist or may hereafter arise in connection with or as a result of my own or my child's participation in the Walk/Run for Umstead and associated activities, including personal injury or damage suffered by me or others, whether same be caused by falls, contact with participants, conditions of the course, negligence of the Releasees or otherwise. If I do not follow all the rules of this event, I understand that I may be removed from the event. I give my full permission to The Umstead Coalition and its local affiliates and their sponsors and corporate sponsors to use any photographs, videotapes, or other recordings of me that are made during the course of this event. rev. 3/1/10 By clicking the send button you agree to accept all the conditions of the liability waiver Pledge Form