31ST ANNUAL YMCA INDEPENDENCE DAY

31ST ANNUAL YMCA INDEPENDENCE DAY 5K
Saturday, July 4, 7:30am
www.ymcaindependencedayrun.org
Join us at the Mt. Trashmore Family YMCA for the 31st Annual July 4th
Annual Giving Campaign 5K and 1/4-Mile Tot Trot to raise money for a
good cause. By participating in this event you are assisting others in your
community with Child Care, Swim Lessons, Health and Wellness programs,
Youth and Teen activities, Older Adult programs and Summer Camp.
The YMCA annual giving program of the YMCA of South Hampton Roads,
helps bring to reality the promise to build strong kids, strong families and
strong communities. Your gift helps ensure that everyone has access to YMCA
programs regardless of their ability to pay. Thank you for your support.
TIMELINE
Friday, July 3
11am–7pm
Packet Pick-up
Saturday, July 4
6:30–7:30amRegistration
7:30am
5K Run/Walk
8:30am
¼ Mile Tot Trot
9:00am
Awards
Wear your red, white, and blue to show your patriotism;
prizes given for most patriotic wear!
Special Thanks to all our sponsors:
GAIL CLYBURN SETTLE
®
31ST ANNUAL YMCA INDEPENDENCE DAY 5K
¼-Mile Tot Trot
Last Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . First Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Male:
Female:
Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Phone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Email: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Age on race day: . . . . . . . . . . . . . . . . . . . . . . . . . . . Date of Birth: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Team Name (If applicable): . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Adult T-Shirt Size (circle one):
Race:
S
5K
M
L
5K Walk
XL
2XL
¼-Mile Tot Trot (free for ages 3–5)
Mail registration to: Mt. Trashmore Family YMCA, 4441 South Boulevard, Virginia Beach, VA 23452
Or register at www.active.com or www.tidewaterstriders.com.
No refunds, exchanges or transfers. Make checks payable to YMCA.
$25 Until June 5
$30 June 6–July 3
$35 Race Day
Overall Awards
5K Run: Top 3 Male & Female overall finishers/Top 3 Male & Female Masters (age 40+)
Awards to Top 3 Males and Females in all age group divisions
Tot Trot: Ribbons to all participants
5K Walk: Top 3 Finishers
Team Awards
I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I agree to abide by any decision
of the race officials relative to my ability to safely complete the run. I assume all risks associated with running in this event including, but not limited to, falls, contact with
other participants, the effects of weather such as heat and humidity, traffic and the conditions of the road. All such risks being known and appreciated by me. Having read
this waiver and knowing these facts and in consideration for your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release Tidewater
Striders, the City of Virginia Beach, the USTAF, the YMCA of South Hampton Roads, race officials, volunteers and all sponsors, their representatives and successors from all
claims or liabilities of any kind arising out of my participation in this event. I grant my permission to all of the foregoing to use any photographs, motion pictures, recordings
or any other record of this event for legitimate purposes. This is a road race conducted under the rules of the USTAF. I understand this road race is not intended for baby
strollers, baby joggers, headphones, dogs on leashes, roller blades or roller skates and I will abide by these guidelines.
Please read the disclaimer before signing.
Signature. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Parent’s or guardian’s signature if under 18)
MT. TRASHMORE FAMILY YMCA
4441 South Boulevard, Virginia Beach, VA 23452
P 757 456 9622 W www.ymcashr.org
Mission: To put Judeo-Christian principles into practice through programs that build healthy spirit, mind and body for all.