Name: Address: Mile Run 5K T-Shirt Y/N Checks made payable to Perry City.

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1 Perry City 4 th of July-Mile Run & 5K Freedom Run Monday, July 4, 2016-Perry Park 2450 S. 900 W. Registration & Pre-Registration pick up begins at 6:30 a.m. 5K 7:15 a.m. Mile 8:00 a.m. Phone: Male Female Age on July 4 th Bib# Mile Run 5K T-Shirt Y/N Checks made payable to Perry City. Pre-Registration accepted now until June 28 th. Forms & fees can be turned in to Perry City Offices. Fees for both Races: Pre-Registration.$3 Day of Race Registration $5 Add $5 for Perry City Commemorative T-shirt and select size: Youth S M L Adult S M L XL If you register by June 24, 2016 you can add a John Ensign Memorial T-shirt for $5. any and all injuries, and all other consequences suffered by me in this race. Perry City 4 th of July-Mile Run & 5K Freedom Run Monday, July 4, 2016-Perry Park 2450 S. 900 W. Registration & Pre-Registration pick up begins at 6:30 a.m. 5K 7:15 a.m. Mile 8:00 a.m. Phone: Male Female Age on July 4 th Bib# Mile Run 5K T-Shirt Y/N Checks made payable to Perry City. Pre-Registration accepted now until June 28 th. Forms & fees can be turned in to Perry City Offices. Fees for both Races: Pre-Registration.$3 Day of Race Registration $5 Add $5 for Perry City Commemorative T-shirt and select size: Youth S M L Adult S M L XL If you register by June 24, 2016 you can add a John Ensign Memorial T-shirt for $5. any and all injuries, and all other consequences suffered by me in this race.

2 Perry City 4 th of July-Pickleball Tournament Wednesday, June 29, 2016 Starting at 5:00 PM Three Mile Creek Elementary 2625 S 1050 W Register at Perry City Office 3005 S 1200 W Divisions by Age: 1) 19yrs old and under 2) yrs old 3) 50 yrs old & older Phone: Male Female Age Division T-Shirt Y/N Make checks payable to Perry City. Registration accepted now until June 27 th. Fees for Registration $2 add $5 for Perry City Commemorative T-shirt Select size: Youth M Adult: S M L XL any and all injuries, and all other consequences suffered by me in this tournament. Perry City 4 th of July-Pickleball Tournament Wednesday, June 29, 2016 Starting at 5:00 PM Three Mile Creek Elementary 2625 S 1050 W Register at Perry City Office 3005 S 1200 W Divisions by Age: 1) 19yrs old and under 2) yrs old 3) 50 yrs old & older Phone: Male Female Age Division T-Shirt Y/N Make checks payable to Perry City. Registration accepted now until June 27 th. Fees for Registration $2 add $5 for Perry City Commemorative T-shirt Select size: Youth M Adult: S M L XL any and all injuries, and all other consequences suffered by me in this tournament.

3 Perry City Baby Prince & Princess Contest I would like to enter my child in the Baby ( ) Prince or ( ) Princess Contest to be held on Wednesday, June 29, 2016 at 6:30 p.m., at the Church next to Perry City Park. Name: Age: Parents: Phone# Please write something about your baby: Please return this form to the Perry City Offices or Esther Montgomery by June 27, This contest is open to Perry City Residents only. Baby must be 24 months or younger. Awards will be given to each baby. Prince and Princess will be by Luck of the draw. Please write something unique about your baby.

4 UNCLE SAM AND MISS LIBERTY CONTEST I wish to enter my child in the ( ) Uncle Sam or ( ) Miss Liberty contest, to be held at 7:00p.m. Wednesday, June 29, 2016 Contestant: Parents: Brother(s) & Sister(s) Birthday: Favorite Color: Favorite Food: One Wish: What does your child want to be when he/she grows up? Hobbies & Interests: Tell an interesting story about your child: I understand that this contest is open to all children ages 2-6 and who are Perry City residents. The winners will be selected by the Luck of the Draw. Please return this form to the Perry City Offices or Esther Montgomery by June 27, All contestants are invited to ride on a float in the parade Monday, July 4 th with an accompanying parent. Meet at 2700 South 1200 West at 10:45 a.m. Pick up will be in the parking lot of the Perry Stake Center located at 685 West 2250 South. Check here if you would like to be in the 4 th Of July Parade

5 Rules of Participation 1. General Rules: This contest is open all residents of Perry City, Utah. Limit of one performance per person/group. The Contest will be held at the Perry Church located at 685 W 2450 S, Perry City. Contestants must be available on June 29, 2016 at 7:30 pm to compete. The Perry City s Got Talent winners will be announced later that evening. 2. Judging: The contest will be judged by a qualified panel of judges, whose decision will be final. Participants will be judged in a variety of areas, including, but not limited to: performance, appearance, popularity, stage presence, talent selection, etc. Winners will be selected in the following categories: Most Original, Most Patriotic, Most Crazy, Most Glitzy, and Overall Best Talent. The decisions on winner selections and on all matters relating to this contest are final and binding. No correspondence regarding the contest and judging of contestants will be acknowledged or entered into. 3. Dress: This is a family oriented activity. Proper dress is required for all contestants. Perry City and the Sponsors of this contest reserve the right to prohibit nudity or inappropriate dress. 4. Prizes: By accepting the prize, the winner agrees to hold sponsors, their respective directors, officers, employees and assigns, harmless against any and all claims and liability arising out of the contest and use of the prize. Participants assume all liability for any injury or damage caused, or claimed to be caused, by participation in this contest or use/redemption of any prize. Sponsor reserves the right to substitute prize of equal or greater value. All federal, state and local taxes are sole responsibility of winner. All federal, state and local laws and regulations apply. No cash equivalents, substitution or transfer of prize permitted by winner. Entrants agree to be bound by the Official Rules and the decisions of the judges. 5. Performance Requirements: Each participant will perform one act (either unaccompanied or accompanied) of their choice on June 29, Lyrics played for performances must be appropriate or participant may be eliminated from the competition immediately. Participants are responsible for providing music, either by CD track or piano. During performances, participants are responsible for providing CD minus track accompaniment. Musical equipment will be provided by Sponsor, within reason. 6. Deadline for Application is June 24, 2016 at 5:00pm. Applications must be turned in to the Perry City office before the deadline in order to considered for award. 7. No acts involving live animals will be allowed.

6 PERRY S GOT TALENT CONTESTANT INFORMATION FORM Solo Acts: If your act includes you alone, please fill out this page only. Group Acts: If your act includes 2 or more people, there must be a main contact person, plus page two of this application needs to be filled out. Name: Address: City: Address: Date of Birth: Home Phone: Cell Phone: If you are a group, how many people are in your group (must be Perry City Resident) What is the age range of your members (for example:8-14yrs old): Of this number, how many are under the age of 18 years? Talent Category (check ALL that you think apply to your act): Singer Musician Dancer Magician Juggler Comedian Other (please explain): Please list the Title and Artist of the song(s) you are singing and/or performing to: and I,, certify that I have read and understand the Rules of Participation and agree to adhere to them, if for any reason I do not follow the Rules of Participation I understand that I may be disqualified. Name of Applicant (Print) Signature of Applicant Signature of Parent/Gaurdian (if applicant is a minor)

7 GROUP INFORMATION SHEET PLEASE LISTALL MEMBERS OF YOUR GROUP STARTING WITH THE NAME OF THE MAIN CONTACT PERSON WHO COMPLETED PAGE 1, IF THAT PERSON ALSO PERFORMS IN THE ACT. If space is needed for additional group members, please copy this page and attach all additional pages behind Page 2.