5K Paint Run - Northeast Columbia Young Life

DIRECTIONS
To
Clemson Sandhills
Research & Education
Clemson Sandhills
Research & Education
Cle
m
son
Ro
ad
Tw
oN
ot
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Ro
ad
Sandhills Mall
CONTACT
Northeast Columbia Young Life
P.O. Box 5772
Columbia, SC 29250
Kit Southwick, Area Director
802-309-4744
[email protected]
Sponsored By:
From Clemson Road, enter at traffic light
across from Sandhills Mall. Follow the
signs for parking and registration.
FLATPOSSUMLLC.COM
5K Paint Run
REGISTRATION
First Name:_____________________________________
Last Name:_____________________________________
Address:_______________________________________
City: ________________ State: _____ Zip:____________
Date of Birth: __________ Age: _____ Gender:__________
Email Address:___________________________________
Phone: ____________________ T-shirt size:___________
ENTRY FEE: $25 (Adult)
$20 (Ghost Runner) I won’t be able to run but
still want to support someone for camp!
$10 (under 10 years old)
Optional Tax-Deductible Donation:_____________________
What is
?
Young Life
Our mission in Young Life is to meet and love high
school kids where they are in their lives. We strive
to build relationships with them and show them that
there is more to life through Christ. Our hope is to
lead them into a relationship with Christ, to walk
along side of them and help them grow in their faith.
Northeast Columbia Young Life has over 30 volunteer
leaders in our 5 high schools in the northeast. These
high schools are Richland Northeast, Spring Valley,
Ridgeview, Blythewood and Westwood.
RACE DAY
Sunday April 17th
Race starts at 3:00 pm
(check-in starts at 2:30 pm)
Sandhill Research & Education Center
900 Clemson Rd, Columbia, SC 29229
We suggest you wear black if you
want “paint” thrown on you!
Total Amount Enclosed:____________________________
I would like my costs /donations to fund:
Student:_______________________________________
School: ________________________________________
$20 of your registration fee will go straight towards
campership of your student or school of your choice.
Please Make Checks Payable and Mail to:
Northeast Columbia Young Life
P.O. Box 5772
Columbia,SC 29250
Signature: ______________________ Date:___________
Parent/Guardian Signature:__________________________
(If participant is 17 years of age or younger)
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 agreed to abide by any decision of
a race ocial relative to my ability to safely complete the run. I assume all risks associated
with participating in the Northeast Columbia Young Life 5K Paint run on April 17, 2016,
including, but not limited to, falls, contacts with other participants, the eects of weather,
including high heat and/or humidiity, conditions of the course, all such risks being
known and predicated by me. Having read this release and knowing these facts and in
consideration of your accepting my entry, I, for myself and anyone entitled to act in my
behalf or on behalf of my estate, waive and release all sponsors of the race, any persons
assisting with the race, the ocers, Committee, Committee members, agents, servants,
employees and their successors and assigns of each and every of the above from all
claims or liabilities of any kind arising out of my participation in the race even though the
liability may arise out of negligence or carelessness on the part of the persons referred
to in this waiver. I also grant permission for the use of any photographs, motion pictures,
recordings, or any other record of my participation in this event for any legitimate
purpose. I understand that if the race is canceled because of any circumstances beyond
the control of the race committee and sponsors, including, but not limited to, unsafe
weather conditions or governmental ban, my entry fee will not be refunded.
This 5k is to raise money for high school
students from Northeast Columbia go to a
Young Life camp in Jasper, GA called
Sharptop Cove this summer July 19-25!
REGISTER BY:
1. Mailing in attached form or
bringing it with you on race day
OR
2.Register online at
http://goo.gl/forms/LXnfblPVYs