2007 Pieathlon - Fundraiser for Cancer Care and Cancer Research
2007 Pieathlon - Cancer Fundraiser - Adel, Iowa
Bike, Run, Eat Pie and help the fight against cancer in Iowa.
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Raising Funds for Iowa Cancer Research and Care

Penny’s Pieathlon
Online Registration

Saturday, June 28rd, 2008
Adel, Iowa

Kinnick City Park
8am Walk / Run
9am Bike Ride
10am Swim

Pieathlon, Inc. is an Iowa Non-profit Corporation
Federal ID# 20-8428307

Pieathlon Fees

Teens and adults $25. After May 15th, 2008 $30.
Children with parent or guardian are free (optional T-shirts below)

  • Raccoon River Valley Weekend Pass included
  • Official 2008 Pieathlon Shirt Cotton T included
  • High Performance 2008 Pieathlon Shirt *add $6 (adult sizes only)
  • A slice of pie! (thanks to Theresa Finnegan of AstraZeneca)

There is a $4.00 processing fee added to all online registrations to cover administrative costs. This fee is not charged when paying with a check by mail.

Printable Registration Form and Waiver (PDF)

Please complete ALL fields
One Name Per Registration

First Name:
Last Name:
Male/Female:
Male Female
Birthdate:
- -
Age Day of the Pieathlon:
Address:
City:
State:
Zip:
Daytime Phone:
Home Phone:
Email:
Check One:
Ok, share my information with sponsors
Privacy please, do NOT share my information with sponsors
Check One or Two - one walk/run and one bike
Walk/Run:
1 mile 5K 10K
Bike:
10 mile 25 mile 50 mile
Swim:
1/8 mile 1/4 mile 1/2 mile
Official 2007 Pieathlon Shirt Cotton T included
Select T-Shirt Size:
Adult S M L XL XXL
Optional Child's T-shirt:
Cost $16.00
X-S(2/4) S(6/8) M(10/12) L(14/16)
High Performance T 2007 Pieathlon Shirt *add $6
(think under armour, adult sizes only)
  Yes, High Performance No, Cotton T
I would like to make an additional donation to Iowa Cancer Fund:
Donation Amount:
enter amount in dollars and cents (100.00) no $ sign.
I would like to make an additional donation to Livestrong, Lance Armstrong Foundation:
Donation Amount:
enter amount in dollars and cents (100.00) no $ sign.
Discount Code:
Pieathlon Participant Waiver

I, the undersigned, know and understand the Pieathlon and it’s related events involve potentially hazardous or dangerous activities. I attend the Pieathlon and all related events out of my own free will and accept and assume all risks , whether before, during or after scheduled events. These risks include, without limitation physical injury, mental injury, emotional distress, trauma, sickness, illness, death, contact with other participants, equipment failure, inadequate safety equipment, effects of weather, traffic, contact with motor vehicles of all types and descriptions, collision with other riders, runners or fixed objects, the conditions of the road, negligence of others participating in the event and along the route. All risks are know and appreciated by me and I waive any and all specific notice of the emergency expenses in the event of injury, illness or other incapacity regardless of whether I authorized such expenses. I authorize the; use and release of personal and medical information in connection with any medical service provided to me.

I realize Pieathlon events require physical conditioning. I represent that I am in sound medical condition capable of participating in the events without risk to myself or others. I am solely responsible for the condition and adequacy of my bicycle, running and safety gear. I will walk, run and/or ride safely within the limits of my own abilities, my equipment and the conditions in a manner that does not endanger myself or others.

Knowing these facts and in consideration of my entry acceptance and participation in the Pieathlon related events I, for myself, spouse, heirs, next of kin, assigns and anyone acting on my behalf, release, waive, discharge, covenant not to sue and agree to hold Pieathlon organizers, sponsors, participating clubs, communities, volunteers, emergency personnel, beneficiary organizations, city, county and state governments, property owners, law enforcement  agencies, Raccoon River Valley Trail Organization,  Lance Armstrong Foundation, Mercy Cancer Center, John Stoddard Cancer Center,  the officers, directors, friends,  advisors employees, representatives, agents or successors of all the above. My waiver and release of all claims, demands, actions and liabilities shall include without limitation, any personal injury, accident, illness or death a do any property damage or loss that may be : (a) caused by any act, or failure to act, by the above identified persons and entities,  including without limitation, their negligence, errors, omissions, failure to enforce rules and conditions of the routes or event premises and /or (b) sustained by me before, during or after the Pieathlon and it’s related events. I am signing this agreement freely and voluntarily and intend by my signature for this to be a complete and unconditional release of all liability to the greatest extent allowed by law. I understand that my name, address, photograph, voice and or likeness may be used in promotional or advertising materials by the Pieathlon organizers, city of Adel, RRVT Association, LAF, Livestrong,  Mercy Cancer Center, or John Stoddard Cancer Center.

I further agree to indemnify and hold the parties released above harmless from any and all losses, damages, claims and expenses, including attorney’s fees, arising from or relating in any respect to my attendance and or participation in the Pieathlon or its related events or my breach of this agreement.

I have Read, Understand and Agree with the Pieathlon Participation Waiver.

The typing of your name in this form constitutes a legal signature.

Participant Signature:
Parent Signature:(If Under 18)
Today's Date: - , 2008
Payment Type: Credit Card    Check By Mail

Please make sure that all information is correct before submitting.

 

Benefitting LIVESTRONG - Lance Armstrong Foundation

This event is hosted by a Lance Armstrong Foundation (LAF) fundraiser to raise funds for the LAF. This is not an official LAF-hosted event.
All Proceeds go to Iowa Ovarian Cancer Research, the Lance Armstrong Foundation, Local Iowa Hospitals Mercy Cancer Center & the John Stoddard Cancer Center.
 

Printable Registration Form and Waiver (PDF)

Event Director: Dave Milburn
Email:
Phone:515-276-2378
Fax: 515-276-2378
6249 Country Ridge Lane
Johnston, IA 50131

 

   

Copyright 2007-2008 Pieathlon, Inc. Johnston, Iowa

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