the form here.

Transcription

the form here.
Sunday, April 12, 2015  15K Start: 7:00 a.m.  5K Start: 7:10 a.m.
Mail to Racetime sports
478 E. Altamonte Drive
Suite 108-716
Altamonte Springs, 32701
Checks payable to Riverside Dash
Mailed entries must be postmarked by 3/27/2015
OR Register online at www.riversidedash.com
PLEASE PRINT
NAME: ______________________________________________________________________________________________________
ADDRESS: ______________________________________________________________ TEL: _____________________________
CITY: __________________________________________________ STATE: ______________________ ZIP: ________________
_____ 15K _____ 5K SEX: __________ AGE: ________ BIRTHDATE (mm/dd/yyyy): ______/______/______
ENCLOSED: $________ Entry fees are nonrefundable. Credit cards accepted during online registration only. Cash or Check only accepted on race day.
SHIRT SIZE: Free gender specific tech shirt to all paid registrations. Sizes are not guaranteed for late registration.
WOMEN’S S(___) M(___) L(___) XL(___)
MEN’S S(___) M(___) L(___) XL(___)
EMAIL ADDRESS: __________________________________________________________________________________________
I know that participating in this event is a potentially hazardous activity. I should not enter unless I am medically able and properly trained. I agree to
abide by any decisions of a race official relative to my ability to safely complete. I assume all risks associated with participating 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 your accepting my entry, I, for
myself, and anyone entitled to act on my behalf, waive and release the City Sanford, the County of Seminole, Fleet Feet Sports, Seminole County Regional
Chamber of Commerce and any and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my
participation in this event even though that liability may arise out of negligence on the part of persons named in this waiver.
SIGNATURE: ________________________________________________________________ DATE: ______________________
Parent if race participate is under the age of 18
RACE ENTRY FEES
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Bright House Networks 5k:
$25 before 2/1
$30 from 2/2 – 3/1
$35 from 3/2 – day of registration
Chase 15k:
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$50 before 2/1
$55 from 2/2 – 3/1
$60 from 3/2 – 4/1
$65 from 4/2 – day of registration
LOCATION
Fort Mellon Park
Sanford, FL
www.RiversideDash.com
AWARDS Ceremony at 9:15 a.m.
15K & 5K: FINISHER’S MEDALS TO ALL
Top Overall Male & Female; Top Male & Female Master;
Top 3 in Age Groups 16 & under; 17-24, 25-29, 30-34, 35-39, 40-44, 45-49,
50-54, 55-59, 60-64, 65-69, 70+
EARLY PACKET PICKUP:
TBA
TIMING & SCORING: This event will be professionally managed and timed.
All participants will receive a personal chip on their race bib.