2nd annual 5k run - 5k fitness walk registration form

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2nd Annual 5K Run - 5K Fitness Walk • Saturday, September 24th Register 7:30 • Run / Walk Starts 8:30 at the High School • Dry-Wick Shirts guaranteed to Pre-registered • Breakfast following 5K • Virtual Runner? • Entry Fee - Adults $20 | Students $10 5K Run Age Groups Men & Women: 13-19, 20-29, 30-39, 40-49, 50-59, 60 & over Fitness Walk: OPEN to all, Non-Competitive 2nd Annual 5K Run - 5K Fitness Walk Each Participant must complete a registration form Name_________________________________________Date of Birth_______________ Male / Female Address________________________________________E-Mail__________________________________ City/State______________________________________Phone_________________________________ SIGNATURE__________________________________DATE_________________ M/DD/YYYY Register by Sept. 9 to ensure T-Shirt T-Shirt Size: Youth/Adult S M L XL XXL 5K Run 5K Walk 5K Run - 5K fitness walk Virtual Runner Waiver: In consideration of foregoing, I myself, executors, administrators, and assigns, do hereby discharge Jackson R-2 Foundation and all sponsors from any and all claims of damage, actions, and causes whatsoever, in any manner arising or growing out of my participation. Make Checks payable to: Jackson R-2 School District Foundation Do you have other plans on Sept. 24th? Would you prefer sleeping in or doing something else rather than getting up early to run or walk? You can do virtually anything else you want and still support the Jackson R-2 School Foundation!!! You can have the best of both worlds! This level or participation accomodates your busy schedule. Virtual Runner participants will receive a t-shirt. Please return to: Jackson R-II Board Office, 614 E. Adams St. Jackson, MO 63755 Sat u r d ay , S e pte m b e r 2 4 , 2 0 1 1 Satu rday, Septe mb e r 2 4 , 20 1 1

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Page 1: 2nd Annual 5K Run - 5K Fitness Walk Registration Form

2nd Annual 5K Run - 5K Fitness Walk

• Saturday, September 24th Register 7:30• Run / Walk Starts 8:30 at the High School

• Dry-Wick Shirts guaranteed to Pre-registered

• Breakfast following 5K• Virtual Runner?

• Entry Fee - Adults $20 | Students $10

5K Run Age Groups Men & Women:13-19, 20-29, 30-39, 40-49, 50-59, 60 & over

Fitness Walk:OPEN to all, Non-Competitive

2nd Annual

5K Run - 5K Fitness Walk

Each Participant must complete a registration formName_________________________________________Date of Birth_______________ Male / Female

Address________________________________________E-Mail__________________________________

City/State______________________________________Phone_________________________________

SIGNATURE__________________________________DATE_________________

M/DD/YYYY

Register by Sept. 9 to ensure T-Shirt

T-Shirt Size: Youth/Adult S M L XL XXL 5K Run 5K Walk

5K Run - 5K fitness walk

VirtualRunner

Waiver: In consideration of foregoing, I myself, executors, administrators, and assigns, do hereby discharge Jackson R-2 Foundation and all sponsors from any and all claims of damage, actions, and causes whatsoever, in any manner arising or growing out of my participation.

Make Checks payable to: Jackson R-2 School District Foundation

Do you have other plans on Sept. 24th? Would you prefer sleeping in or doing something else rather than getting up early to run or walk? You can do virtually anything else you want and still support the Jackson R-2 School Foundation!!! You can have the best of both worlds! This level or participation accomodates your busy schedule. Virtual Runner participants will receive a t-shirt.

Please return to: Jackson R-II Board O�ce, 614 E. Adams St. Jackson, MO 63755

Saturday, September 24, 2011

Saturday, September 24, 2011