Khiet Luong Pennsylvania Environmental Council 1315 W alnut

Or register online:
www.phillywatersheds.org/cobbscreek5k
Khiet Luong
Pennsylvania Environmental Council
1315 Walnut, Suite 532
Philadelphia, PA 19107
You are invited to the
Place
Stamp
Here
Saturday, April 23, 2011
8am-12pm
63rd & Cedar Street
Philadelphia, PA
(Re)Discover your Park!
Please join us on Saturday, April 23rd, for the First Annual Cobbs
Creek 5k. This run/walk is one of the many new and exciting events
happening in Cobbs Creek Park this year.
With the help of the Darby-Cobbs Watershed Partnership’s Public
Education & Outreach Committee, this race will help support new
family programs in the park. In 1999, the Darby-Cobbs Watershed
Partnership was formed in an effort to connect residents, businesses,
and government as neighbors and stewards of the watershed.
To find out more information about us, please visit:
www.phillywatersheds.org
To register online for the 5k, please visit:
www.phillywatersheds.org/cobbscreek5k
Many thanks to our sponsors:
Registration
Waiver and Release
Online registration: www.phillywatersheds.org/cobbscreek5k
Please complete this form or register online, if possible. If you wish,
please include a donation (checks only please).
All checks must be made payable to the Fairmount Park
Conservancy.
Please return this document with the included pre-addressed label
on the front of this brochure by Monday, April 18th in order
to participate on Saturday, April 23rd. Registrations may also
be taken on the day of the event – runners will be charged an
additional $5 fee.
Cost: Runners: $20
Group of 5 Runners: $60
Walkers: $15
Group of 5 Walkers: $40
Youth (Ages 13 - 18): $10
Children (Ages 12 and under): Free
In consideration for accepting this entry and the granting of the right
to participate in the event, I, the undersigned, intending to be legally
bound, hereby waive, for myself, my heirs, personal damages I may
have against the Darby-Cobbs Watershed Partnership, Philadelphia
Parks and Recreation, Pennsylvania Environmental Council, Fairmount
Park Conservancy, City of Philadelphia, its partners, officers, directors,
employees and sponsors, and/or any person whomever for any and all
injuries, including death, that may result from my participation in said
event. I represent and affirm that I am in proper physical condition to
participate in this event as verified by a licensed physician and have
sufficiently trained for completion of this event. Further, I hereby grant
full permission to the above event to use my name and/or picture in
any newspaper, photographs, video tape, motion picture, recordings
or any other account of this event for any purpose whatsoever and
without any obligations of anyone to compensate me therefore.
The undersigned has read and voluntarily signed this release and
waiver.
I am unable to participate, but will support the Cobbs Creek Park
through a tax-deductable donation of $__________________.
_____________________________________________________
Participant’s Signature
I would like to contribute $______________ for another runner/
walker to participate.
(Parent/Guardian must sign if participant is under 18).
_____________________________________________________
Signature of Parent/Guardian
Please Print Clearly:
Date:_________________________________________________
Participant’s Name:____________________________________
Street:______________________________________________
City:__________________________State:_____ Zip:________
gLh
CONCEPTS
GRAPHIC DESIGN • GLHCONCEPTS.COM
Home Phone: _________________Work :___________________
Darby-Cobbs
Wa t e r s h e d
Partnership
Important Information
There will be a RAFFLE available at the event with PRIZES such
as a cool roof, a rain barrel, gift certificates, and much more!
All registered runners will be timed.
A bag check will be provided.
All participants will receive a T-shirt.
E-mail: _____________________________________________
Age: ___________ Gender: M/F
T-Shirt Size (Circle): Small Medium Large X-Large 2XL
Emergency Contact:
Name: ______________________________________________
Phone:______________________________________________
Relation:____________________________________________
Schedule of Events
Registration: 8:00 am
Warm-up: 8:45 am
Run Begins: 9:00 am
Walk Begins: 9:30 am
Start: 63rd & Cedar Street
End: Cobbs Creek Community Environmental Education Center
We encourage the use of public transportation but parking is available
along 63rd Street.
Public Transportation
Train: Market-Frankford line to 63rd Street
Bus: 21,31,42
Trolley: 34
For more information, please:
Visit the website at: www.phillywatersheds.org/cobbscreek5k
Call Mr. Khiet Luong at: 215-545-4570 x 107