Brain Drain Zombie 5K Entry Form

Last Name First Name M.I.

Address City/State/Zip Code

Age DOB (MM/DD/YY) Gender Phone Number

Email

T-shirt Size: S M L XL 2X ($1 extra)

Participating as a: Human Zombie

ALL PARTICIPANTS MUST SIGN RACE WAIVER. I know that running or walking a road race is a potentially hazardous activity. I should not participate unless I am medically able and properly trained. I also know that, although police protection will be provided, there will be traffic on the course route. I assume the risk of running into traffic. I also assume any and all other risks associated with running this event including but not limited to falls, contact with other participants, the effects of the weather including cold temperatures , rain and/or snow, and the condition of the roads, all such risks being known and appreciated by me. Knowing these facts, and in consideration of your accepting my entry, I hereby for myself, my heirs, executors, administrators or anyone else who might claim in my behalf, covenant not to sue, and waive, release and discharge the University of Southern Indiana, all sponsors, the State of Indiana, City of Evansville, Vanderburgh County, race officials and volunteers, any and all claims of liability for death, personal injury or property damage of any kind or nature whatsoever arising out of, or in the course of my participation in this event. This Release and Waiver extends to all claims of every kind or nature whatsoever, foreseen or unforeseen, known or unknown. The undersigned further grants full permission to the University of Southern Indiana, Pott College of Science, Engineering, and Education Student Advisory Board, all sponsors and/or agents authorized by them, to use any photographs, video tapes, motion pictures, recordings or any other record of this event for any purpose. Application for minors will be accepted only with parent’s signature.

Signature of Participant (over 18) Date Signature of Parent of Minor Participant Date

Mail entry to: USI Cashier’s Office 8600 University Boulevard Evansville, IN 47712

For more information: usi.edu/running/zombie-run

Checks payable to: USI Cashier’s Office. Note in memo: Brain Drain Zombie 5K 18096-01780

Individual Registration

Participants may register to run in the Brain Drain Zombie 5K for $35 as an individual prior to October 18. Late registration is $40 after October 18. Includes Brain Drain Zombie 5K T-shirt, participant or survivor medal, Brain Drain bib, race packet and admittance to Zombie Blood Bash.

Team Registration

Team registration consists of at least five people and the cost is $30 per person prior to October 18. Late team registration is $35. Includes Brain Drain Zombie 5K T-shirt, medal, race packet and admittance to Zombie Blood Bash. Team Registrations should submit all registration forms at one time with check.

Zombie Registration

Zombie registration is $20 which will not only allow you to crawl after the runners flags, but includes official Brain Drain Zombie 5K t-shirt, race packet, admittance to Zombie Blood Bash and a professional zombie transformation. We will only accept the first 75 zombies on a first come-first served-basis.

BRAIN DRAINZOMBIE 5K

Sponsored by:

OCTOBER 25, 2014

The proceeds allow the Pott College of Science, Engineering, and Education Student Advisory Board to offer programming and provide professional development opportunities for student clubs within the college.

The Pott College of Science, Engineering, and Education Student Advisor Board will provide support and advice on matters of interest to the College, its faculty, students and external constituents. The goals and activities of the board will include but are not limited to: • Assessing and addressing needs of Pott College

students• Providing an outlet for student ideas• Advising the assistant dean of issues affecting students• Encouraging student involvement in Pott College

activities, initiatives, programs, etc.• Serving as ambassadors of the College• Assisting in creating and promoting a positive image for,

and understanding of, the College and its programs

The Zombie Brain Drain 5K is a run with a twist. Prior to the race, participants will be given three flags. Throughout the race, zombies will attempt to capture the participants’ flags and “eat their brains.” Obstacles will be set up along the way to challenge participants when they are not being chased by the zombies. Time does not matter, but participants need to run as quickly as possible throughout the Zombie Zones before the horde of the undead claim them as one of their own.

PACKET PICK-UPLocations: Subaru October 23 4:30-7 pmUSI Quiet Lounge October 24 4:30 - 7 pmGrimes Haus October 25 3:30 - 5 pm

SURVIVOR AND ZOMBIE AWARDS Each individual and team survivor will receive an event survivor t-shirt and medal if they cross the line with at least one health flag. Awards will also be given for best male and female zombies.

OFFICIAL RULES1. Participants under the age of 18 must bring a printed consent form signed by a parent or legal guardian. We will not be able to let you participate in the run otherwise. Children under 14 years of age will not be able to participate in the Zombie Brain Drain5K event.

2. All participants must wear a Brain Drain bib with their participant number clearly shown on the front of their attire.

3. Runners must not take another runner’s flags, chase other runners or pick up flags from the ground.

4. Runners may choose to skip obstacles. Please alert a course official if you cannot complete an obstacle. If you skip an obstacle, you will still be able to finish the race.

5. Flags must be visible to course officials and zombies. The flags may not be covered by long clothing and must be worn on the sides of the body.

6. Runners and zombies must not have direct or intentional physical contact. Runners and zombies must not touch, hit, punch, tackle, scratch or do any other harm to each other’s physical health. Violations of the rules will automatically disqualify, runners or zombies will be escorted from the premises without a refund.

7. Teams are allowed and recommended to assist in making it through the 5K course.

THE BRAIN DRAIN ZOMBIE RUN RACE

PURPOSE OF ZOMBIE RUN POTT COLLEGE STUDENT ADVISORY BOARD PURPOSE

INFORMATION

C14-110417

BRAIN DRAINZOMBIE 5K

THE OBSTACLES

A series of man-made obstacles will be physically challenging, but not impossible. The obstacles will test strength, speed and the teamwork between fellow survivors. Participants will need to climb, crawl, duck and dive their way to the finish line. The obstacles will include the Brain Drain Blood Pit, Pipe Tunnels, Drain Slide, Horror Corridor Maze, Tire Pit and Fence Crawl.

THE COURSE

The course begins at the Grimes Haus and maneuvers through the wooded area into the Broadway Complex. The rugged terrain and hills along with the obstacles makes this 5K course one that all participants will remember. The race begins at dusk under the lights. Anything could happen when you enter the Brain Drain Zombie 5K course.

SPONSORED BY:

Presented by the Pott College of Science, Engineering and Education Student Advisory Board