Event Registration Form

Please fill out the registration form that best fits you and your family and indicate if you want Option 1 or 2 or both.

Option 1: ________  I will participate in the “YMI Running” event and I agree to help YMI fundraise.  I will try to raise up to $200.00 through a personalized fund-raising page sent out to friends, co-workers, neighbors and family to support my efforts at various levels.  Under this option, YMI will pay for one registration fee as long as the participant agrees to fundraise for YMI.  If the fundraiser wishes to have other family members run in the event, the fundraiser agrees to pay YMI the Geist registration fee of $35.00 for the 5K, $45.00 for the 10K and $60.00 for the half-marathon.

Participant         First Name                     Last Name (if different)                               Grade & Date & YR of Birth

#1 __________________________________________________________________________________

#2 _________________________________________________________________________________

#3 _______________________________________________________________________
#4 _______________________________________________________________________

Name of Participant(s) That Will Participate In The:


5K _________________________________________________________________________________

10K ______________________________________________________________________
Half-Marathon ______________________________________________________________
Shirt Size(s)
Youth Size(s)           #YS_____   #YM_____   #YL______   #YXL_____
Women’s Size(s)     #S______     #M_____     #L_______    #XL______     #XXL_________
Men’s Size(s)           #S______     #M_____    #L_______     #XL_______    #XXL_________    #XXXL__________
Participants Contact Information
Cell Phone Number: __________________________________________________________
Email Address: ______________________________________________________________
Option 2: ______  I will or will not participate (please circle either I will or I won’t) and I would like to pay for some mentees to participate in the event who can’t afford it.  Please accept my amount of $_________________ to go towards mentees fees in need or please accept $_________________ this as a general donation to go towards YMI.
Please return form and payment (if paying for other family members, YMI mentees or you are making a general donation) by April 22, 2017 to:  YMI, P.O. Box 743, Fishers, IN 46038
For Questions, Please Call or Contact: YMI Executive Director, Todd Melloh
(317) 417-3525 todd@ymionline.org