5th Annual St

12th Annual
Saturday, September 5, 2015
Raising Funds for
The Arc of Howard County, Inc.
FISH of Howard County, Inc.
The Shrine of St. Anthony
and Other Local Charities
8:00 A.M.
SAVE THE DATE
On the grounds of The Shrine of St.
Anthony, Ellicott City, Maryland
Race Course Information: The 10K race starts and finishes at the Shrine of St. Anthony, 12290
Folly Quarter Road, Ellicott City, Maryland 21042. It takes you through scenic western Ellicott
City countryside and surrounding neighborhoods. It is USATF Certified: MD07010JS, and is
open to traffic. The 5K race also starts and finishes at the Shrine. The first half is on Folly
Quarter Road and the second half is through rough terrain on the Friary premises. The ¾ mile
Fun Walk is entirely on the premises, as is the ¾ Mile Fun Run for children age 12 and under.
Race Day Information:
Saturday, September 5, 2015 (Rain or Shine)
6:45
Race Day Registration & Packet Pick Up
8:00
10K & 5K Races
8:05
¾ Mile Fun Walk & ¾ Mile Kids Fun Run
Additional Information: Go to www.kc11898.com for more
on the race.
Awards/Amenities: 1st, $75; 2nd, $50; 3rd, $25 to the first three men and women in the open
division for both the 10k & 5k races. Non-cash awards in 7 age group categories. Lots of
activities including food, music, moonbounce, massages, and random prize giveaways.
T-Shirts: Guaranteed to participants registered by August
13th with maximum 4 per family registration.
Event Management/Timing: www.bullseyerunning.com
Race Director: Doug Angradi  410-531-7594
[email protected]
2014 Sponsors
2014
Concetta Corriere & Jim Jeppi Realtors RE/MAX 100 ♦ Dixon Hughes Goodman LLP - CPA's and Advisors
Donald J. Enright - Long & Foster ♦ Commercial Construction ♦ Clarks Ace Hardware ♦ Sandy Spring Bank
Juice Plus+ ♦ Boarman’s Meat Market ♦ AutoStream Car Care ♦ Safeway, Inc. ♦ Clarksville Exxon ♦ Wegmans
Entry Form – Please print clearly
Fees (non-refundable):
Pre-registration (postmarked by Aug. 13)
 Individual - $25.00
 Family up to 4 - $55.00
 Kid’s FR - $10
Regular Registration (postmarked by Aug. 29)
 Individual - $30.00
 Family up to 4 - $65.00
 Kid’s FR - $10
Late/Race Day Registration
 Individual - $35.00
 Family up to 4 - $75.00
 Kid’s FR - $10
 Please accept my contribution of
$_______
Does your employer provide matching funds? Yes  No 
 Additional T-shirts, _____ at $10 each; add $2 for each XXL
$_______
Complete and return form with payment to:
Knights of Columbus Charity Fund
P.O. Box 85  Clarksville, MD 21029
Total: $_______
Name ____________________________________ 10K  5K  Walk  Kids 
Official Use Only
Address ___________________________________________________________
A
City ___________________________________ State ______ Zip _____________
Age _______________ DOB ____________________ Male  Female 
Home Phone _________________________ Email ___________________________________
List ALL names of additional participants:
Sex
Event
2._______________________________________ _____ ___________
M/F
10 / 5 / W / K
3._______________________________________ _____ ___________
M/F
10 / 5 / W / K
4._______________________________________ _____ ___________
M/F
10 / 5 / W / K
T-Shirt Size(s): (one per individual/four per family, plus paid additional): Youth: _____ YM
Adult: _____ S
_____ M
_____ L
Age
_____ XL
DOB
_____ XXL (add $2)
None: _____
Liability Waiver: I know that running a road race is a potentially hazardous activity and that I should not enter and run 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. I assume all risks associated with running in this event, including, but not limited to: falls, contact with other participants, the effects of the weather, including high heat and/or humidity, traffic and the conditions of the road, all such risks being known and
appreciated by me. Having read this waiver and knowing these facts and in consideration of you accepting my entry, for myself and anyone entitled to act on my behalf, I waive and release organizers of the Ellicott City Labor Day Running Classic 10K & 5K,
Knights of Columbus, Franciscan Friars, Race Director, volunteers, and all sponsors of all claims, damages, demands and any action whatsoever in any manner arising from my participation in said athletic event. I attest and verify that I have full knowledge of
the risks involved in this event. Further, I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for legitimate purposes.
If under 18, parent or
guardian’s signature
1. _______________________________________________
Date ___________
3. _______________________________________________
Date ___________
2. _______________________________________________
Date ___________
4. _______________________________________________
Date ___________