Place:

The run will start in front of the Eldon Pool at Air Park, North Franklin St.

Next to the Air Port….

Start:

Saturday, October 10, 2015. Race Starts at 12:00 p.m.

Sign-in & late registrationwill begin at 11:00 a.m. and ends at 11:30 a.m.

YOU ARE STRONGLY ENCOURAGED TO PRE-REGISTER.

Course:

3.1 miles (5 kilometers) (No dogs allowed)

Entry Fee:

$20 pre-registration received before 9/18. Registration received9/19or later, $25.

Race Packets:

Your shirt with race number will be available at registration. In order to beguaranteed a t-shirt, you need to pre-register. Forms need to be returned to the address below beforeSeptember 18, 2015

Late registration will be $25 if not received beforeSeptember 18.

Registration Forms & Course Route

Additional registration forms and course route are available on our website:

Mail the registration form and $20(or $25) to:

Shauna Clemons · 405 W 8th St · Eldon, MO 65026

Make check to Benefit for Jamison Clemons

Awards:

Special awards to top male and female finishers.

Medals will be awarded to the top finishers in each division.

Jamison ReWalk 5K

Saturday, October 10, 2015 Race starts at 12:00 p.m.

Name______Age (as of race day) ______

Address______Male Female

City______State______Zip______

Please Indicate Runner Walker E-mail: ______

Pick One T-Shirt for $20.

5KSelect Shirt Size:YOUTH: Lg  ADULT:Sm Med  Lg XL XXL

PLEASE READ AND SIGN RELEASE & WAIVER ON THE NEXT PAGE

Release & Waiver: By signing this form understand and agree to the following information. Pictures taken at the event can be used for Jamison ReWalk publicity such as Facebook, Newspaper and website. I know that running is a potential hazardous activity. 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 race, including but not limited to falls, contact with other participants, the effects of weather, including high heat/ humidity, the conditions of the road and traffic on the course, all such risks being known and appreciated of my applications, I, for myself and anyone entitled to act on my behalf, waive and release the event, and all sponsors, their representatives and successors from all claims or reliabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. All fees are nonrefundable.

______

Signature Date Parent’s Signature if under 18