IAMBK 5K Charity Walk/Run Saturday- April 11, 2015

IAMBK 5K Charity Walk/Run
Saturday- April 11, 2015
Fun Run for Kids (1 mile)—8:30 am (ages 8-12)
5K Adult Run—9:00 am
Email: [email protected]
Online Registration:
website: www.iambkinc.org
Mail to: P.O. Box 769; Auburn, Al 36830
ENTRY FEES:
Child
Early Registration (through 2/15/15)
Regular Registration (2/15/15—4/10/15)
Race Day Registration (April 11)
Adult
$10
$15
$20
$20
$25
$30
Registration forms and payment can also be dropped off at the Boykin Community Center office in
a sealed envelope . Make all checks payable to IAMBK.
Guaranteed T-Shirt Deadline: 3/27/15
Registration/Packet Pick-Up:
Friday, April 10th
Boykin Community Center Office
Saturday, April 11th (Race Day) Boykin Auditorium
Time ___________
6:00—7:00 am
Awards Ceremony @ 10:00 am
Awards: All 1 mile finishers will receive treat bags. Prizes awarded to 1st, 2nd, and 3rd overall for
men and women and group awards in each age group:
14 and under
15-19
20-30
30-40
40-50
50 and up
Official Entry Form
Check one:
Fun Run for Kids
________
5K Run for Adults
________
Please circle size: (5K only)
YL
YXL
S
M
L
Name : _____________________________________________
Sex: (circle one)
Date of Birth:
Age:
______________________________________
XL
2XL
M
F
____________
Address: ____________________________________________________________________________________
City: __________________________________
State: __________
Zip Code: __________________
Phone: ________________________________
Cell: _____________________________
Email: _______________________________________________________________________
Waiver/Event Disclaimer:
This release must be signed by each participant or the parent/guardian of each participant. By adding your
signature, you accept this waiver and disclaimer. I know that running a road race is a potentially hazardous activity. I
should not enter and run the IAMBK 5K Charity Walk/Run unless I am medically able. By participating in this Event, I
do so at my own risk. I assume all risk of injury, illness, damage or loss to me or my property that might result, including without limitation, any loss or theft of personal property. I consent to medical treatment in the Event of injury, accident and/or illness during the Event. I agree on behalf of myself (and my personal representatives, heirs, executors, administrators, agents and assigns) to release and discharge the organizers of this Event, its principals, its officers and directors, its staff, all sponsors and their representatives from any and all claims or causes of action (known or unknown)
arising out of their negligence. I acknowledge that I have carefully read this ‘waiver/Event Disclaimer and fully understand that it is a release of liability. By my signature below, I am waiving any right that I may have to bring legal action
to assert a claim against any and all Event sponsors for their negligence. I hereby grant full permission to any and all of
the foregoing to use my name and likeness in any broadcast, telecast, video or print media reporting or advertising of
the Event without compensation.
I AGREE
Sign here:
___________________________________________________________