Docstoc

5k

Document Sample
5k Powered By Docstoc
					THE      COLONIA 5K CLASSIC                                                                                                                                                                  THE
                                                                                                                                                                          COLONIA 5K CLASSIC
(ONE ENTRY PER APPLICATION - application may be reproduced)


                                                                                                                               FOR OFFICIAL USE ONLY                           presented by: St. John Vianney
I am entering (check one only).............                       5K Run                                    Kids’ Fun Run
ENTRY FEE                                                         $18.00 - 5K Run                           $10.00 Kids’ Fun Run                              RACE DATE: SATURDAY MAY 16, 2009
                                                                  $20.00 Day of Race
                                                                                                                                                              START:      CHRIS JANTAS FUN RUN 8:30 A.M.
        FIRST NAME                                                    MI        LAST NAME

                                                                                                                                                                          5K RACE                           9:00 A.M.
        ADDRESS (Include Apt. #)                                                                    USATF #
                                                                                                                                                              PRE-REGISTRATION DEADLINE: MAY 9, 2009
        CITY                                                                                           STATE              ZIP
                                                                                                                                                              ENTRY FEE: 5K RACE                            $18.00
                                                                                                                                                                             DAY OF RACE                    $20.00
        BIRTH DATE                AGE (on race day)               Male     Female                HOME TELEPHONE
                                                                                                        -                  -
                                                                                                                                                                             CHRIS JANTAS FUN RUN $10.00

                                                  CHECK ONE (NO EXCEPTIONS)                                                                                      USATF certified course (flat, fast)
                                                                                                                                                                 Cash awards to top 3 male & female finishers
                                  SHIRT SIZE                                               GUARANTEED TO ALL                                                     All timing & scoring done by CompuScore
                             S         M          L          XL                            PRE-REGISTERED RUNNERS                                                Awards for top 3 male & female finishers in each age group
                                                                                                                                                                 And other prizes

                        FOR MORE INFORMATION CALL (732) 815-1431                                                                                                         You will receive your race number and
                                                                                                                                                                         information packet the day of the race.
                             REGISTER ONLINE AT WWW.ACTIVE.COM
                                                                                                                                                                                 FOR INFORMATION CALL:
                 INCOMPLETE OR UNSIGNED FORMS WILL NOT BE ACCEPTED                                                                                                                  (732) 815-1431
LIABILITY AND PUBLICITY RELEASE: (failure to sign with date will delay processing of your application) Please accept my entry in the Colonia 5K
Classic. I hereby state that I have conditioned myself to participate in the event I have chosen. I, for myself, my executors, administrators and                                   (732) 574-0150
assignees, do hereby release and discharge St. John Vianney parish, officials, sponsors, and volunteers from damages or injuries occasioned by my
participation in the Colonia 5K Classic. I also authorize the Colonia 5K Classic officials to utilize any photographs and video tape of my participation in
the Colonia 5K Classic for any and all purposes. By signing my name below, I hereby certify that I have read all the terms and conditions of this release
                                                                                                                                                              DIRECTIONS: GARDEN STATE PARKWAY TO EXIT 131 (ISELIN,
and do intend to be legally bound thereby. No baby joggers or strollers allowed.                                                                              METUCHEN, ROUTE 27), GO RIGHT OFF EXIT, MAKE A RIGHT AT
                                                                                                                                                              W OOD AVENUE (FIRST INTERSECTION), MAKE A RIGHT AT THIRD
_____________________________________ Date:                                                _____________                                                      TRAFFIC LIGHT - INMAN AVENUE, FOLLOW APPROXIMATELY 1 MILE
                                                                                                                                                              TO CHURCH ON LEFT SIDE OF STREET.
Signature (Parent/Guardian if under 18)
           ABSOLUTELY NO REFUND ........ THE RACE WILL BE HELD RAIN OR SHINE                                                                                  NOTE: FOR THE SAFETY OF OUR RUNNERS, LOCAL ROADS CLOSE
                                                                                                                                                                    AT 8:00 A.M. PLEASE PLAN TO ARRIVE EARLY.
   Make check or money order payable to:                                    MAIL TO: The Colonia 5K Classic
                                                                                                                                                                     ACTION SPORTS PHOTOGRAPHY WILL BE ON HAND TO TAKE
    St. John Vianney - Colonia 5K Classic                                            c/o St. John Vianney                                                     ACTION SHOTS OF THE RUNNERS. PRE-ORDER YOUR 8X10 FOR $ 10.00
                                                                                     420 Inman Ave, Colonia, NJ 07067                                         AND $ 5.00 WILL BE GIVEN BACK TO THE ORGANZATION. THE PICTURE
                                                                                                                                                              WILL BE TAKEN AS THE RUNNER CROSSES THE FINISH LINE. ADDITONAL
                                                                                                                                                              PICTURES WILL BE AVAIABLE ON LINE FOR PURCHASE. MAKE CHECKS
                                                                                                                                                              PAYABLE TO SJV – COLONIA 5K CLASSIC
                                                                                                                                                              YES PRE-ORDER MY 8X10 _______________ AMOUNT ____________

				
DOCUMENT INFO
Shared By:
Categories:
Stats:
views:19
posted:6/1/2011
language:English
pages:1