22nd Annual Fall 15K and 3X5K Relay The only 15K in Madison Sunday October 18, 2015 Hosted by Race Sponsors Proceeds Benefiting the Leukemia and Lymphoma Society 9 am Race Proceeds Majority of the race proceeds benefit the Leukemia and Lymphoma Society. An estimated 1,012,533 people in the United States are living with, or are in remission from, leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma or myeloma. Approximately every four minutes, someone new is diagnosed with blood cancer. Approximately every 10 minutes, someone dies. The Leukemia & Lymphoma Society offers the most comprehensive array of services to blood cancer patients and their families. The Leukemia & Lymphoma Society®, headquartered in White Plains, NY, with 68 chapters in the United States and additional branches in Canada, is the world’s largest voluntary health organization dedicated to funding blood cancer research and providing education and patient services. The Society’s mission: to cure leukemia, lymphoma, Hodgkin’s disease and myeloma, and improve the quality of life of patients and their families. If you wish to make an additional contribution to the Leukemia and Lymphoma Society you may do so at the race site or please write one check which includes race entry fee and your additional donation. Please make note in the memo line regarding the additional donation..

Fall 15K & 3X5K Relay Registration Form If under 18, a parent or guardian signature is necessary. Signature: Date: Send completed registration and check payable to: 2000 Observatory Drive, Room 1180 Running UW-Madison Madison, WI Circle one: 15K run 3X5K relay Names of other relay team members address: Phone: City: Name: Last Address: Pre-registration is $15/person and $45/relay team, postmarked by 10/13/14. Late or day of registration is $20/person and $60/relay team. Competitions Men’s and Women’s 15K run Men’s, Women’s & Coed 3X5K relay Date, Time, and Place Sunday, October 18, 2014 Start Time 9 a.m. Warner Park, Madison, WI Pre-registration: $15 per person, $45 per relay team (must be postmarked by 10/13/14) Late or day of registration: $20 per person, $60 per relay team Online Registration available at (maximum processing fee $1.02) Entry fee includes headband, race number, food, beverage and raffle prizes. Packet pick-up: Oct 17 th at the Movin’ Shoes Store in Madison 1:00pm - 5:00pm OR day of race at the Warner Park Shelter 7:30 - 8:45am Registration Relay teams are encouraged to provide their own transportation to the relay exchange zone (same drop off area for 5K and 10K exchange). However, transportation can be provided to relay exchange zone and to the finish line for relay participants. If you wish to be part of relay and are looking for relay team members, contact Ron Carda at or and we will assist in helping find relay teammates as best as we can. Relay Information The race starts and ends in Warner Park. The course includes some rolling hills. Walkers, baby strollers, and baby joggers are welcome. No pets, roller/inline skates allowed. Course closes at 11am. Quick Course Facts Race Proceeds Majority of the race proceeds benefit the Leukemia and Lymphoma Society. Age: Sex (circle): Male Female Each member of relay team needs to fill out a registration form. Please consider mailing all forms/entry fees in a single envelope. Team Name: Team Type (circle): Male Female Coed (for announcement of running club races) RELAYS: The relay race consists of a three (3) member team, with each member running a 5K leg. Waiver – I understand that running is a potentially hazardous activity. I shouldn’t enter unless I’m medically able and properly trained. I assume all risks associated with running in this event. Having read this waiver and accepting my entry, I, for myself or anyone entitled to act on my behalf, waive and release the Board of Regents of the University of Wisconsin System, its officers, employees and agents, the Running Club at UW-Madison, the City of Madison, and Dane County, WI from all claims or liabilities of any kind arising out of my participation in this event. I understand that the University has no medical coverage and that any medical expenses I incur are my responsibility. I have read this waiver and understand it. I understand that participation is voluntary and I freely choose to participate. First State:Zip: For More Information: