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Mail to: Jubilee Youth Ranch 29 Jubilee Circle., Prescott, WA 99348 Each participant MUST complete an Entry Form. To register additional participants, please duplicate this form or download forms or register online at www.jyranch.org.

Kid Zone

(Use this form if you’re only bringing a kid out to have some serious fun!)

Child #1 _______________

M

F Age ____

Child #2 _______________

M

F Age ____

Child #3 _______________

M

F Age ____

Child #4 _______________

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F Age ____

Celebrate community by making a difference in the lives of youth.

Please Check: 5K RUN MALE FUN WALK FEMALE T-SHIRT SIZE: XS S M L XL XXL (Circle one) Name:_____________________________________

Name:_____________________________________

Address:___________________________________

Address:___________________________________

City:________________ State:______ Zip:________

City:________________ State:______ Zip:________

Phone:________________________ Age:________

Phone:________________________ Age:________

Email Address:_____________________________

Email Address:_____________________________ Original artwork by Jubilee student, Ramon E. - Phoenix, AZ

ENTRY FEE:

ENTRY FEE:

$20 -5K Run

$5 per child or $20 per family of 4 or more children

$20 – Family Fun Walk (Includes entry to Kid’s Zone) Sorry, I am unable to participate, but I would like to

Sorry, I am unable to participate, but I would like to

make a donation of __________

make a donation of __________

LATE REGISTRATION: Postmarked After 6/5/11

LATE REGISTRATION: Postmarked After 6/5/11

$25 -5K Run

$6 per child or $24/per family of 4 or more children

$25 – Family Fun Walk (Includes entry to Kid’s Zone) Checks payable to: Jubilee Youth Ranch Checks payable to: Jubilee Youth Ranch Total Enclosed:____________________ I hereby waive and release any and all rights and claims I may have against Jubilee Youth Ranch, Broetje Orchards, and the Run/Walk Sponsors for injuries/damages that may occur out of this event. Further, I hereby grant full permission to any and all of the foregoing to use any pictures, or any other record of this event for any purpose whatsoever. If signed by a parent, the parent agrees to release and hold the above named organizations and persons harmless of any claims which may be asserted by or on behalf of the entrant.

__________________________________________ Signature Date

The Jubilee “Fruit Loop” 5K Run & Family Fun Walk Saturday, June 18, 2011

Registration - 9:00am 5K Start - 9:45am 1 Mile Family Fun Walk - 11:00am Location - Jubilee Youth Ranch

Total Enclosed:____________________ As parent/legal guardian, I hereby waive and release any and all rights and claims I may have against Jubilee Youth Ranch, Broetje Orchards, and the Run/Walk Sponsors for injuries/damages that may occur from participation in the Kid Zone Activities. Further, I hereby grant full permission to any and all of the foregoing to use any pictures, or any other record of this event for any purpose whatsoever. If signed by a parent, the parent agrees to release and hold the above named organizations and persons harmless of any claim(s) that may be asserted by or on behalf of the entrant(s).

_______________________________________ Signature

Date

509.522.2323 Walla Walla, WA


RUN/WALK INFORMATION LOCATION: From Walla Walla • Drive north on Highway 125 to Highway 124 • Turn left (west) onto Highway 124 • Follow 124 to Eureka Road (at mile marker 21) • At mile marker 21 turn right onto Eureka Road

From Pasco • Take Highway 12 East approximately 5 miles • Highway 12 crosses the Snake River on a cream-colored bridge • At the light turn left onto Highway 124 to Waitsburg & Clarkston • Follow 124 to Eureka Road (at mile marker 21) • At mile marker 21 turn left onto Eureka Road

From Eureka Road • Follow for 7 miles to stop sign at Sheffler Road • Turn left onto Sheffler Road • Take the first soft left onto Van Hollebeke Road • Follow that up a short hill and veer to the right • Follow Van Hollebeke for approximately 2 miles to Jubilee Circle • Follow the signs to parking

DATE: Saturday June 18, 2011 START TIMES: 5K Start Time – 9:45am Family Fun Walk - 11:00am EARLY REGISTRATION FEE*: $17 - 5K Run $13 - Family Fun Run $5 - Kids Zone (Max. $20 for 4 or more)

*T-shirts provided for all pre-registered participants.

LATE REGISTRATION: (Received after 06/05/2011) $20 - 5K Run/Walk $15 - Family Fun Run $5 - Kid Zone (Max. $20 for 4 or more) RACE DAY REGISTRATION: $25 - 5K Run/Walk $20 - Family Fun Run/Kids Zone $6 - Kid Zone (Max $24 for 4 or more) RACE DAY CHECK IN: 9:00 AM – 9:45 AM

No numbers will be issued after 9:30 AM.

RULES OF COMPETITION: For the safety of all participants and to satisfy insurance requirements, no skates and animals permitted on course. ADDED AMENITIES: Lunch provided for all registered participants. KIDS ZONE: Bounce castles, carnival games, popcorn, snow cones & cotton candy, horse rides & miniature golf.

MISSION STATEMENT Providing a Christ-Centered environment where youth can find new beginnings. PROGRAM DESCRIPTION: Jubilee is a structured, positive learning environment that offers the benefits of talented staff dedicated to helping young men gain the tools needed for success. Our 12 month, residential program integrates educational, spiritual, and personal growth curricula with our vocational skill building activities, athletics, and community service learning projects. This integration, combined with our relationship-focused approach, provides full student engagement and results in demonstrated success. An interdisciplinary team works with each student, creating an individualized development plan that outlines objectives and goals for the student’s success. Jubilee Youth Ranch 29 Jubilee Circle Prescott, WA 99348 Phone - 509.749.2103 Fax – 508.749.2076 Email – Jubilee@jyranch.org Website – www.jyranch.org


Jubilee Fruit Loop Brochure