2020 Runner’s Stampede
VIRTUAL RACE
Rec Center staff wanted to continue a 4th of July
tradition during these unprecedented times
and is offering a VIRTUAL RACE for 2020.
Complete a 5K walk, 5K run or 10K run anytime,
anywhere! Participants all over the country can
commit to starting their day with some active fun
& receive a commemorative race t-shirt.
2020 Runner’s Stampede
Entry Form
1. Check the race you are entering
Only one entry per application, please.
5K Walk 5K Run 10K Run
2. Division
Check gender and age group.
Male Female
13 & under (5K only) 14-19 20-29
30-39 40-49 50-59 60 +
3. T-Shirt Size
Small__ Medium__ Large__ X-Large__ XX-Large__
Mail Shirt ____ Local Pick Up:___
Local Pick Up is preferred when possible!
4. Name and Contact Information
Full Name
Address
City State Zip
Phone
E-mail ______________________________________
5. Terms of Participation
Please read this waiver carefully, and let us know if you have any quesons or concerns.
When registering yourself, your spouse, or your minor child/children for membership and parcipaon in
acvies and programs sponsored by the Paul Stock Aquac & Recreaon Center you will be waiving and
realizing all claims for injuries you, your spouse, or your minor child/children might sustain arising out of the
use of the facility menoned above.
I hereby give my consent for myself, spouse or minor child/children to parcipate in recreaonal acvies
sponsored by the Cody Parks & Recreaon Department in Cody, Wyoming, during any session of the recreaon
program. I HEREBY RELEASE THE SHOSHONE RECREATION DISTRICT, RECREATION DIRECTOR, RECREATION
STAFF AND BOARD OF DIRECTORS, THE CODY PARKS & RECREATION DEPARTMENT, THE CITY OF CODY, AND ALL
CITY STAFF ASSOCIATED THEREWITH FROM ALL LIABILITY, INCLUDING CLAIMS AND SUITS AT LAW OR IN EQUITY
FOR ANY INJURY FATAL OR OTHERWISE, INCLUDING BUT NOT LIMITED TO CLAIMS FOR NEGLIGENCE, while
parcipang in any of the recreaon acvies and understand that I will be fully responsible for any damage or
injuries incurred by the parcipant while involved in any Recreaon Department acvity.
Also, I hereby pledge to provide posive support, care and encouragement for my fellow competors and
league ocials by following this Code of Ethics. I will encourage good sportsmanship by demonstrang posive
support for all players, coaches and ocials at every game. I will treat other players, coaches, fans and ocials
with respect regardless of race, sex, creed or ability. I understand that I am parcipang in a recreaon acvity
and agree not to use profane language or engage in ‘trash talking’ at any me. I will lead, by example, in
demonstrang fair play and sportsmanship to all my fellow competors. I understand that the ocials are
there for my benet and will agree not to direct any profane or threatening acons toward them (either verbal
or physical). I understand that any violaon of this code shall be cause for the Shoshone Recreaon Board &
Cody Parks & Recreaon, in execuve session, to deal with any behavior and/or conduct that are considered by
the Board to be disrupve, destrucve, and/or illegal. Behavioral problems may result in expulsion from the
program without reimbursements.
The Shoshone Recreaon District/Cody Parks & Recreaon Department does not provide any medical insurance
or personal liability to cover parcipants during an acvity. This is the responsibility of each individual involved
in any recreaon acvity.
NOTICE: The City of Cody reserves the right to take and use photographs of individuals using the
Cody Recreaon Center and/or parcipang in programs sponsored by the City of Cody. Such photographs are
the property of the City of Cody, and may be used in brochures, adversements and other promoonal
materials.
Participant
Signature
_________________________Date ________
(Parent/Guardian Signature if Participant is a Minor)
IMPORTANT INFORMATION:
If you’d like a t-shirt by July 4th,
please register by June 16th.
All entries submitted by 6/16 will be mailed
a shirt so you can sport it for your virtual
race!
We will take entries through July 3rd, but
t-shirts will not be mailed before race day
after 6/16.
LOCALS: We would ask that you pick up
t-shirts at the Cody Rec Center.
How to Enter
Return Completed Form To:
City of Cody Parks, Recreation
& Public Facilities
1402 Heart Mountain Street
Cody WY 82414
Or Mail:
Completed form with payment to
City of Cody
Runner’s Stampede
PO Box 2200
Cody WY 82414-2200
To Enter Online:
Go to
www.cityofcody-wy.gov/159/Runner’s-Stampede
complete fillable form and
e-mail to kellys@cityofcody.com,
or fax to 307-587-2565.
You will be called for credit card information
REGISTRATION FEE $30
PLEASE DO NOT SEND CASH
MAKE CHECKS PAYABLE TO CITY OF CODY
For m ore information
call 527-3487 or email
kellys@cityofc ody.com
Registration Code: 260004
click to sign
signature
click to edit
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