Name:____________________________ Phone:____________________
Address:____________________________________________________
Event: _______1 Mile Walk/Run       _______5K Walk/Run
Make Checks Payable to: OEF (Okarche Educational Foundation)
Registration Fee: $15.00 (12 years and younger)     $20.00 (Over 12 years)
Add: $2.00 for XXL shirts            Add: $3.00 for 3XL size shirts
**Registration fee includes a t-shirt**
T-shirt size                   _____Youth S              _____Youth M            _____Youth L
                                    _____Adult S               _____Adult M             _____Youth L
                                    _____Adult XL             _____Adult 2XL           _____Adult 3XL
 
Amount Enclosed: _________________             ________Check       _______Cash
 
If using this form for multiple entries, please list individual names below:
 
__________________________________________________________________________________________
Mail entry form and registration fee to: OEF, PO Box 324, Okarche, OK  73762
Or turn into the office at the Okarche Elementary School
 
Waiver/Release: In consideration of acceptance of this entry, I waive any and all claims for myself and my heirs against officials and sponsors of the Okarchefest Mad Dash for illness or injury which may result directly from my participation in this event.  I also grant permission for my name and likeness to be used in photographs, video recordings or any other record of this event for any legitimate purpose in supporting the Okarchefest Mad Dash…
 
 
Signature:_______________________________________ (Parent’s signature if under 18)   Date:___________________