Steve Weatherford`s 4 Annual ���Rush the Punter��� 5K Dash ��� Kids Fun

Transcription

Steve Weatherford`s 4 Annual ���Rush the Punter��� 5K Dash ��� Kids Fun
Steve Weatherford’s
4th Annual “Rush the Punter”
5K Dash – Kids Fun Run
Saturday, April 11, 2015
Fairbanks Park – front of YMCA Bldg.
9:00 AM – Kids 1 Mile Fun Run (K-3 grades)
9:30 AM – Kids 1 Mile Fun Run (4-8 grades)
10:00 AM – 5K Dash/Walk
Registrations must be postmarked no later than March 27, 2015 to receive a race t-shirt. Entry is NON-REFUNDABLE. All participants
will enjoy on course entertainment, chipped timing by Timing MD. Kids will receive a finishers medal.
REGISTER ON-LINE AT: https://getmeregistered.com/RushthePunter
1. SELECT EVENT
Event
On time
Late Registration
(postmarked by 3/27/15)
(by 4/6/15)
� 5K Dash
$20.00
� Runner � Walker 5K runners will begin first. Walkers will follow.
$25.00
$ _________
� Kids 1-Mile Fun Run
$10.00
� K-3 Grade Fun Run (8:30 AM) � 4-8 Grade Fun Run (9:00 AM)
$15.00
$ _________
Total: $ _________
All race registration forms must be received by April 6, 2015
2. REGISTRATION INFORMATION (One form per participant)
First Name: ___________________________________________ Last Name: _____________________________________
Mailing Address: ________________________________ City: ___________________________ State: ____ Zip: _________
Male � Female �
Age on Race Day: ______ Grade: _______ School (if applicable):_______________________________
(Please note – If you sign up under a Vigo Co. School, all race packets will be delivered to that school on Friday, April 10)
Adult T-Shirt Size* (circle): S
M
L
XL XXL │ Youth T-Shirt Size*: YS
YM
YL *shirt sizes are not guaranteed
E-Mail: ____________________________________________________ Phone # __________________________________
3. LIABILITY WAIVER (Please read carefully and sign below)
I do hereby relinquish all liability toward the United Way of the Wabash Valley, Vigo County School Corporation, City of Terre Haute, Terre Haute Parks Dept.,
event sponsors and event volunteers for any damages that may happen to occur during this event. I also understand there are no refunds of fees.
__________________________________________________
______________
Signature (if under 18 years of age, parent or legal guardian must sign)
Date
Mail this entire form and make checks payable to:
United Way of the Wabash Valley, c/o Rush the Punter
2901 Ohio Blvd. Suite #215, Terre Haute, IN 47803
TITLE SPONSOR:
For more information call the United Way Office at 235-6287
GOLD SPONSORS:
Coldwell Banker - Crossroads Cafe/Corner Grind – Subway - Sun Factory Tanning - Thompson Thrift
5K participants
compete in the
following Male
and Female age
groups:
Under 19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60+