Saturday, May 17th, 2014
At Boys & Girls Club of Marino County, 565 Oak Street
Marion, OH 433302
Benefits Boys &
Girls Club of Marion County
Race Day
Registration Opens at 7:30am
Kids Fun Run
Starts at 8:30am- Adult 5k starts at 9:00am
Awards for category
and overall winners
Cost:
Kids Fun Run (11 years & under)- FREE
Adult 5k- $25 with Pre-registration or $30 on Race Day
(T-shirt guaranteed if registered by May 1st,
2014)
Pre- register online or at the Club (565 Oak Street
Marion, OH 43302)
Checks made payable to: Boys & Girls Club of Marion
County)
United Way of Marion
County Agency Partner
Info: Maggie Breeding (740)387-3462 [email protected]
I know that running and
road racing are potentially hazardous activities. I will not enter this race
unless I am medically able and properly trained. I assume all risks associated
with this event, including but not limited to, falls, contact with other participants,
the effects of the weather including low temperature and/or precipitation,
traffic, and the condition of the road, all such risks being known and
appreciated by me. Having read this waiver and knowing these facts, in
consideration of accepting this entry, I, the undersigned, intending to be
legally bound, for myself, my heirs, executors, and administrators, waive and
release any and all claims for damages I may have against the Boys & Girls
Club of Marion County from any and all liabilities, claims, demands, and causes
of action whatsoever arising directly or indirectly from my participation in
this event. I also release my rights to any photos, videos, images, etc. taken
of me during this event.
Name: ________________________________________
Age:____________ Gender: F
M
Address:
_____________________________________ Date of Birth: ________________
_____________________________________ Circle one: Kids Fun Run 5K
Phone:
______________________________________ T-shirt Size: Sm
Med LG XLG
Signature:
____________________________________
Please Print Legibly