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    2017 Registration form



Race Day   -   Tuesday,  July 4, 2017

Two Rivers Park        -       Glenwood Springs, Colorado                                                                                                                                                       

Sign-in starts at 7:00AM        RACE at 8:00AM

 

Cost:  Adults (18 yrs+) = $20.00,  17 & under = $10.00   before July  1st

                       Race Day costs?    $25  and  $15                               Make check to:   Lions Club Firekracker 4K.

   

 

 

Last name  (PRINT) _____________________________________________           First name___________________________

Address_________________________________________________________________________________________________

Phone no._____________________________                                                     email_________________________________________

Male____          Female____                                                                                                                                        age on 7/4/2017_______________

 

                                                                               Tee shirts available on limited basis 


 

Race day late Registration:        7:00AM – 7:45AM                                                                                                                Bib no. _________

                                                                                                                                                                                                                                          (will be assigned)

 

 Mail this registration                        Lions Club Firekracker 4K

              and payment to:                    213 Pine St.

                                                                    Glenwood Springs, CO  81601

(by June 27 to assure delivery) 

 

Fine print

I acknowledge Waiver of Responsibility of race directors, organizers, volunteers and sponsors of the race for any damages or injuries caused by my participation in this event.              I am responsible for my own safety.

 

 _______________________________________________

Signature of participant, parent or guardian if under 18 years.

 

 

Questions??    Please contact Darrell Stanley,    [email protected],    970-618-0596


Additional information,  including directions,  at        http://firekracker4K.webs.com

 

The Glenwood Springs Lions Club wishes to  THANK      Alpine Bank,  Berthod Motors,  Bighorn Toyota,  Downtown Drug,  Dalby,Wendland & Co. P.C.,  Glenwood Caverns Adventure Park,  Glenwood Hot Springs,  Glenwood Insurance,    Glenwood Springs Ford,    Grande Optics,    Iron Mountain Hot Springs,    Mountain Chevrolet, 

Post Independent,   Roaring Fork Furniture,   Roaring Fork Liquors,   Sandy's Office Supply,   20/20 EyeCare,

Valley View Hospital,  Independence Run & Hike, and Walmart  for their generous sponsorship and commitment to our community.