View Document you can print out your registration if you are going

SPONSORED BY PORT ISABEL ISD

When: Saturday, April 27, 2013 at 8:00 a.m.

Where:  Starting at the Port Isabel High School and ending at the gazebo near the Port Isabel Library.

Transportation back to starting point will be available.

Why: To help raise awareness about Autism- the fastest growing developmental disorder in the US.

Registered participants are eligible for DOOR PRIZES!!! (Must be present to win)

On-site registration at Port Isabel High School – April 10, 18, 24 & 26, from 4:00-6:00 p.m.

Fill out information on registration form, if interested in purchasing a t-shirt for $ 10.00.

April is National Autism Awareness Month. Statistically 1 in 88 births will result in a child with Autism. Come join us for a family friendly walk and run down Highway 100 and put on the puzzle in support of the many faces of Autism served by Point Isabel ISD.

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This is a FREE event!

Return a separate registration form for each participant to any PIISD school or scan and email the registration forms to autismawareness@pi-isd.net by April 10, 2013.

Circle One:  Walk – 2.2 miles                     Run – 5K

T-shirt size:  Adult – S/M/L/XL/XXL/XXXL                   Youth – S/M/L/XL

___________________________________________________                    ________________________________________________________

                        Name                                                                                                   Signature                                        

ADDRESS/CITY/STATE/ZIP: ______________________________________________________________________________________

Age if under 18: ____________________                                                PHONE: _____________________________________________

YOUR EMAIL FOR INFORMATION UPDATES: ___________________________________________________________________

Waiver:  By submitting this form, you agree to indemnify and hold harmless the Point Isabel ISD and the Autism Awareness Walk & Run organizers from  all cost, expense and liability arising out of my or my child’s participation in this event.  I do hereby waive all claims for damage or loss to me or my child’s person or property which may be caused by an act, or a failure to act, by PIISD, its officers, agents or employees arising directly or indirectly from my or my child’s participation in this event, and I hereby assume liability for any loss, damage or other liability from such event.