Since
1975

Brill Area Community Club - Information
and Donation Opportunities

First Annual 5K Walk-Run
and
1-Mile Kids Walk-Run
Information and Registration:

Click here> the download link
and print a copy of the registration form.
Fill out and send in with
your entrance fee (check).


1st ANNUAL Brill Harvest Days 5K Walk/Run
Saturday, September 9th, 2017
Presented by Grace Lutheran Church and the Brill Area CommunityClub

REGISTRATION at the BRILL FEED MILL:  8:00 – 8:45 AM
WE START WALKING/RUNNING AT:  9 AM

Pre-registration by August 22:
Ages 9 and Up - $15 – and then $20 after 8/22

Family of 4 (2 adults, 2 kids): $40 – and $50 after 8/22

1-Mile Kid's Race: 8 and under $10 period (pre-registration encouraged!)

NOTE: Registration after 8/22: T-shirt not guaranteed (Registrations are non-refundable and non-transferrable.)

COURSE: Paved road (gravel shoulders). Race starts and finishes at the Brill Feed Mill. NO bikes or skates please. Canine friends on leash welcome!

AWARDS: First, second and third place finishers (overall) will receive a free pancake breakfast with all the fixin’s!
Kid’s Race Awards: Medals to top three finishers!

Please print clearly and fill out all information below.

Sign and mail this form with your check to:
Jeanette Mutchler, 2981 27-1/2 Street, Birchwood, WI 54817

Checks payable to: Jeanette Mutchler (Proceeds to fund Grace Lutheran Church and Brill Area Community Club)

 ***Note: 1 Runner/Walker  OR 1 Family Group per registration form. ***

Questions? Contact ‘J’ Mutchler 612-701-5715 or check us out online at: brillharvestdays.com

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Individual: First Name: ____________________________ Last Name: _______________________________________
Address: _________________________________________________________________________________
Email: ___________________________________________________________________

T-Shirt: S  M  L  XL  XXL
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Family Group: First Names: _______________________________ , _____________________________,
                             _______________________________, ____________________________
Last Name: _____________________________________________
Address: _________________________________________________________________________________
Email: ___________________________________________________________________

T-Shirts (write in quantity of each size desired):  _____S _____M _____L _____XL ______XXL

Amount enclosed: $___________

WAIVER: In consideration of my signing this agreement, I enter this event at my own risk and assume any risk or responsibility for injuries I may incur as a direct or indirect result of participation in this event. I also agree not to hold liable any representatives or employees of the Brill Harvest Days Planning Committee, Brill Area Community Club, Grace Lutheran Church, Brill Feed Mill, The Village of Brill, the Town of Oak Grove or the County of Barron for said injuries.

Signature: ____________________________________________________ Date: ______________________
(Parent or guardian if under 18 required.)