Country Elementary Camper Scamper Camper Scamper 5K Race

Country Elementary
Camper Scamper 5K Race
Sunday, May 15,
15, 2016
2016
(race held on Lakeland Trail behind Country Elementary)
WHERE:
Country Elementary School
2939 E M-36, Pinckney, MI 48169
WHEN:
Sunday, May 15, 2016
RACE DAY: late registration from 7:30 – 8:45 am
RACE DAY:
Country’s 5K Camper Scamper is a family-oriented
running/walking event to support the benefits of physical
activity and encourage kids to get out and play. Funds raised will
help provide scholarships to Pirate Camp this summer. The race
is open to everyone and will be held on the beautiful Lakeland
Trail. The race will be timed with prizes for overall male and
female as well as age group awards. Strollers are welcome.
ENTRY FEES:
Register online for this fun fitness event:
http://www.eventbrite.com/e/country-elementary-camperscamper-tickets-23815973217
Packet Pick-Up 7:30 – 8:45 am
5K starts at 9:00 am
1-Mile Fun Run at 9:45 am
100-Yard Dash at 10:00 am
5K by 5/1 ………..…………...$20 (guarantees race t-shirt)
5K on Race Day……………….$25 (does NOT guarantee t-shirt)
5K (12 yrs & under) by 5/1………...$15 (includes race t-shirt)
5K (12 & under) on Race Day…….…$15 (no shirt guaranteed)
1-Mile Fun Run……………..$10
100-Yard Dash………………….$5
A limited number of t-shirts will be available on race day.
Register early to guarantee your t-shirt!
Return the bottom portion along with payment to your school office
or mail to Country Elementary, 2939 E M-36, Pinckney, MI 48169
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Name ________________________________________________ Age on Race Day____________
Street Address________________________________ City____________________ State_____ Zip _________
Phone _________________ E-mail ___________________ *Teacher’s name:________________
Gender (M/F)________ T-Shirt Size (5K ONLY): Adult (S,M,L or XL) ________ or Youth (S,M,L) ________
Choose one: 5K_____ 1-Mile______ 100-Yard Dash______
**Amount enclosed $___________
*If applicable, please provide the name of your child’s Country Elementary teacher.
**Make checks payable to “Country Elementary PTO.” No refunds under any circumstances.
Running a trail race involves risks of serious injury. Rough footing and other surface defects exist on the course. Motorists, cyclists, pedestrians and animals may accidentally or deliberately create hazards. Also, the physical
strain of a long- distance race can lead to serious health problems, as weather-related conditions such as high heat and humidity, and I agree not to enter unless I am medically able and properly trained. I have read and
understand this statement and agree to assume all risk of personal injury or other physical or emotional ailment. I hereby waive all liability claims against any person or entity connected with the organization of this event
,including, but not limited to the City of Pinckney, Pinckney Public Schools, Country PTO, event sponsors, and their separate officers, employees, and volunteers for any injuries and ailments I may incur from participating in this
event, even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. Further, I hereby grant full permission to any and all of the foregoing to use any photographs, video
tapes, motion pictures, recordings, or any other record of this event for any legitimate purpose.
Signature of Participant
Dated:
Signature of Parent, if participant is under age 18
Dated: