Registration Brochure

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Registration Brochure
Bret Neylon’s
8th Annual
Race 2 Recovery
Presented by Seton Specialty Hospital
& Accident Fund Insurance Company
City:_________________________________
Email:________________________________
State:_____________
Zip:_____________
Phone:______________________________
Street:______________________________________________________________________
Male
Benefiting individuals with
paralysis and spinal cord injuries.
July 20, 2013
Plus Children's Half-Mile Fun Run!
Female
TOTAL ENCLOSED ...... _________
*EXTRA DONATION......._________
Rita Davis 1081 Redwood Drive, Brownsburg, IN 46112
MAIL COMPLETED ENTRY FORM AND PAYMENT TO:
100% Cotton T-Shirt Included or New Balance Dri Fit T-Shirt for $5 Additional (available only until July 7)
T-Shirt size:
ADULT
S
M
L
XL
XXL
youth M
youth L
Pre-registered on or before July 14: $20.00 Standard / $25.00 Dri Fit
Race day: $25.00 (T-shirt not guaranteed)
CHECKS ARE PAYABLE TO: Bret Neylon Paralysis Foundation, Inc.
Cross Country Team (if applicable):__________________________________________
5K Run & Walk
racetorecovery.org
*Contributions are tax-deductible to the extent allowed by the
law. This campaign is administered by the Bret Neylon Paralysis
Foundation, Inc., a not-for profit 501 C (3) organization. Please
discuss the deductibility of your contribution with your tax advisor. The Bret Neylon Paralysis Foundation, Inc. is a nonprofit
organization providing fundraising assistance to paralyzed and
spinal cord injured individuals. For more information, please call
(317) 286-3355.
Moments Photograp
Images courtesy of Greatest
5K
Run
5K Walk
Wheelchair
Name:______________________________________________ Age on race day:________
Platinum & Gold Sponsors
The Bret Neylon
Paralysis Foundaon
The annual Bret Neylon Race to Recovery was
created in 2006. It was developed to assist
Bret and his family with his expenses resulting
from a biking accident that left him paralyzed from the neck down.
The 2013 Race to Recovery, our 8th annual,
is proud to support Bret’s paralysis foundation. The foundation is committed to assisting
paralyzed individuals in central Indiana with
financial support for rehabilitation, medical
costs, and assistive devices.
How you can help!
- Participate in the race
- We need up to 100 volunteers before,
during and after the race.
- Raise pledge monies - $100+ in donations gets free race entry
Additional info available at:
www.racetorecovery.org
Registration &
Packet Pick-Up:
6:30-8:00 am
Opening Ceremony:
8:20 am
Start of 5k Run & Walk: 8:30 am
Children's Fun Run
9:00 am
(Ages 9 & under)
Awards Ceremony:
Bret with his parents Tom and Sue.
•
•
9:30:am
Locaon
Brownsburg East Middle School
1250 East Airport Road
Participants should enter Door #12
on the North side of the school.
Awards
Overall top 3 male and female
Masters top 3 male and female
(Overall and Masters’ winners receive shoes)
Top 2 in each age group (run only)
All Children’s Fun Run finishers
10 & under 11-13 14-16 17-19 20-24 25-29
30-34 35-39 40-44 45-49 50-54 55-59 60+
Participant with top pledge monies turned in
Cross Country team with most participants
(excluding Brownsburg)
• $100 bonus for new course record!
Male: John Poray 15:18
Female: Lucie Mays-Sulewski 17:17
Date _________________
Incomplete/unsigned entries will not be accepted. - Entry form can be copied.
If mailed - this must be postmarked no later than July 14, 2013. NO REFUNDS.
Parent’s or Guardian’s Signature if under age 18_______________________________________________
Signature______________________________________________________
Waiver
I have read the accompanying event information and understand the policies of the event. I know that running and walking a road race is
a potentially hazardous activity. I should not enter unless I am medically able and properly trained. I agree to abide by any decision of a
race official relative to my ability to safely complete the run or walk. I also know that while police protection will be provided, there may be
traffic on the course. I assume that all stakes associated with my voluntary participation in this event, including but not limited to falls, contact with other participants, the effects of the weather, including extreme temperatures, traffic and all conditions of the road, all such risks
being known and appreciated by me. Knowing these facts and in consideration of your accepting my entry, I for myself, my heirs, executors, administrators or anyone else who might claim on my behalf, covenant not to sue and WAIVE, RELEASE AND DISCHARGE City of
Brownsburg, Bret Neylon Paralysis Foundation, Inc., race officials, workers or volunteers, their representatives, successors or assigns for
ANY AND ALL claims of liability, whether foreseen or unforeseen for death, personal injury or property damage ensuring out of or in the
course of my participation in this event. I further give full permission to the above-mentioned sponsor's, organizers, and/or agents authorized by them, to use any photographs, videotapes, motion pictures, recording or other record of the event for any reasonable purposes.
Schedule

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