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LOCATION

The Race/Walk will be held at KalamazooValley Community College located at6767 West O Avenue, Kalamazoo, Michigan.

SPAGHETTI DINNER

There is an optional pre-race spaghettidinner on Friday April 20th starting at 4 p.m.at Kalamazoo Valley Community College.Nikos Landing will be providing a spaghettidinner for interested runners and families.There is an additional cost for the dinner.What better way to carb up the nightbefore the race!!

AGE CATEGORIES(5K Run/Walk)

Men and Womens DivisionsMens OverallWomens Overall

Age Brackets

10 and under, 1014, 1519,2029, 3039, 4049, 5059,6069 and 70 and over

TIMING & RESULTS

Timing and results will be provided by

Great Lakes ChampionChip, Inc. To registeronline and to get results after the race go towww.greatlakeschampionchip.com.

EZ MEMORIAL RUN T-SHIRTS

Every pre-registered participant in theEZ Memorial Run/Walk will receive aMemorial Run T-Shirt. There are no guaranteesfor t-shirts after the registration closing date.Adult sizes only.

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EZMEMORIAL

RUN

EZMEMORIAL

RUN

atKalamazoo Valley

Community College

April 21st

2012

April 21st

2012

atKalamazoo Valley

Community College

RECEIVE MORE INFORMATION AT www.ezmemorialrun.com

and LIKE US ON Facebook atEric-Zapata-Memorial-Foundation

PRE-REGISTRATION FEES(Registered before April 20, 2012)

Spaghetti dinner only $10.00Spaghetti dinner 5K Run/Walk $30.005K Run/Walk only $25.005K Run/Walk Student $20.00Team of 4 (Race only) $80.00

SAME DAY REGISTRATION FEES(After April 20, 2012 no guarantee of t-shirt)

Spaghetti dinner only $12.00Spaghetti dinner 5K Run/Walk $35.005K Run/Walk only $30.00Note: No late team entries

EZ MEMORIAL TEAMS

Register as a team and save. Teams can be madeup of friends, co-workers, family. There is noage restriction. All team registrants must ll

out a separate registration form and return allfour (4) registrations for the team memberstogether, along with the entry fee of $80.00. Allentries must be mailed and postmarked on orbefore April 18th, 2012. After April 20th thereare no team registrations.

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BACKGROUND/PROCEEDS

On April 18, 2011 we all suffered a great losswhen Ofcer Eric Zapata from KalamazooDepartment Public Safety was killed in the lineof duty. He dedicated his life to serving thepeople of Kalamazoo and preserving the safety

of our community. To honor Eric and his legacy,the Greater Kalamazoo Fraternal Order ofPolice Lodge # 98, has partnered with theEZ Memorial Foundation to establish the 1stannual EZ Memorial Run. Proceeds from thisevent will be used to establish a scholarshipfund for individuals enrolling in LawEnforcement programs at Kalamazoo ValleyCommunity College and Grand RapidsCommunity College.

SCHEDULEThe 5K Run/Walk will begin at 9:00 am.Check-in & same day registration begins at7:00 am until 8:30 am at Kalamazoo ValleyCommunity College. Event occurs rain or shine.

PRE-PACKET PICK-UP

& PRE-REGISTRATION

Friday from 4:00 pm until 7:00 pm at KalamazooValley Community College inside of Gym A.

Signs will beposted directingparticipantsto Gym A.

ONLINE

REGISTRATION

CLOSING DATE

WednesdayApril 18, 2012@ 5:00 EST

WAIVER AND RELEASELegal Waiver & Signature: I hereby certify that I have carefully read, understand, and agree to be bound by the terms contained within this Entry Formand will be legally bound by terms of this release (waiver of rights). I certify that I have entered this race of my own free will. I am in a physical conditionthat allows me to enter this event. In consideration of the acceptance of my entry, I do, for myself, my heirs, administrators, executors, and any, andall parties, related to or representing me waive and release now and forever any and all claims, damages, known or unknown, now or in the future, Ihave, or may have in the future against The EZ Memorial Foundation, The EZ Memorial Run, Kalamazoo Department Public Safety, Kalamazoo ValleyCommunity College, its principals, representatives, sponsors, volunteers, and or beneciaries, for any and all injuries, claims, damages, or right to bringany type of claim, suffered by me while traveling to, from, and while participating in the race event. Further, I accept full responsibility and liability forany, and all medical expenses, claims, or damages of any kind, that I may incur, and agree to defend and indemnify, the above named parties, if anyclaim is brought against them by any party on my behalf. I also waive any, and all rights of privacy I may have and agree that my photograph, likeness,or video may be used by race organizers, their representatives, agents, or any other party they grant permission to, to take and use, said photographs,lm, video, or other digital likeness. NOTE: PARENT MUST SIGN IF PARTICIPANT IS UNDER 18 AND PARENT OR GUARDIAN UNDERSTANDSAND AGREES THAT THEY ARE WAIVING THE RIGHTS OF THE MINOR BY SIGNING THIS RELEASE AND WAIVER, TO THE FULL EXTENTALLOWED BY MICHIGAN LAW.

ENTRY FORM

Please print all information clearly and sign form.

________________________________________________Name

________________________________________________Address

________________________________________________City

________________________________________________State Zip

(__________) ____________________________________Phone

________________________________________________

Email

________________________________________________Emergency Contact

________________________________________________Contacts Phone

________________________________________________Team Name

Female Male

Birthdate: ____ / ____ /____

Age on 04/21/12: _________

T-Shirt Size:

Small Medium Large

X-Large XX-Large ($2.00 extra)

I own my own ChampionChip,

my number is: ____________

I will use the ChampionChip provided by

the race and will return it after the race.I understand there will be a $30.00 fee if Ido not return my chip.

Mail entries and checks to:

EZ Memorial FoundationP.O. Box 19706

Kalamazoo, MI 49019-0706

5k Run and Walk $25.00

5k Team Run $80.00

_________________________________________________________________________________________________________Signature or Signature of Parent if under 18 Date

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