Team Captain's Name:

The team captain is in charge of

• registering the company
• encouraging co-workers to participate
• distributing prize bags & T-shirts

We’ll help you out with reminders and suggestions! (See Tip Sheet)

Address:  

City  Zip

Phone:  

Email :

Organization/Company Name: 

Number of employees at company in the Jackson area:

How many posters advertising the event do you want us to drop-off for your company?

The following questions are for you to answer as an individual. You will not need to complete another individual registration form.

There will be free breakfast offered at the following locations. Check which you plan to attend:
Nixon Park     Sharp Park   Pedal and Tour (downtown)    None
(Nixon and Sharp Park breakfast stands will be located in parking areas near the swimming pools)

Will you attend the Smart Commute Day Lunch Party?  yes    no
The Lunch Party will take place from 12pm to 1pm at Bucky Harris park at the corner of W. Michigan and Jackson St.  Free lunch from Lenny’s, prizes, and the presentation of the Smart Commute trophy!

A group of commuters will celebrate Smart Commute Day by riding into Jackson from Concord on the new Falling Water Trail.  They will be leaving Concord at 7:30am. The trail is beautiful in the morning.  This could be your best commute of the year!You can also meet up with the group where the trail crosses Lime Lake at around 8:00am. Would you like to ride along? Yes         No

How many miles roundtrip will you be commuting? (by bike, foot, or transit)

How are you smart commuting?   Walk      Bike      Transit

Are you a first time smart commuter? Yes         No

T Shirt Size   Small      Medium          Large         X Large   XX Large

How did you hear about Smart Commute Day?  At work     JTV        Newspaper     Local race
Fitness Council newsletter/mailing     Other

Submitting this form means you accept the following. I hereby state that I am in good physical condition and able to safely participate in this event. I am aware of the inherent risks in participating in an event of this type and for myself, my heirs, executors, and administrators, waive and release any and all rights and claims for damages I may have against the Fitness Council of Jackson or sponsors arising as a result of my participation in Smart Commute Day. I also authorize permission to all the foregoing to use any photographs of my participation in the event for any legitimate purpose.

Note: Once the team captain has registered the business as a team, each member
must register as an individual! Individual team members can register at any time.