The Chad Reed Memorial Committee introduces the 1st
Captain Chad Reed Memorial 5K Run/Walk
5K Run/Walk Road Race and / 1 mile Fun Run(for Kids 12 & under)
Saturday, June 5, 2010 at 10:00 AM
When:Saturday, June 5, 2010. Registration begins at 7:30am, 5K race starts at 10:00 am,
Kids Fun Run (1 mile) starts at 10:30 am.
Location:Dixie County High School16077 SE 19hwy, Cross City, FL32628
Course:3 Mile Course Starting at DixieCountyHigh School –Ending at the Dixie County Trail Riders Club
Registration:Runners & Walkers may pre-register by mail or online:
Entry Fee:Received or Postmarked by May 15, 2010$25.00
Race day registration$30.00
T-shirts:Pre-registered runners/walkers will receive a t-shirt
Food:Barbeque & Fish Fry Tickets will be sold at the registration table$5.00
5K Awards:Running Awards: Male & Female – 1st Place for overall, 2nd Place, and 3rd Place
Walking Awards: 1st, 2nd & 3rd for Overall Male & Female to Cross the Finish Line
Special Awards: Team with the most Participants/Team from Farthest Away
Schedule:8:30 am – Registration & Packet Pick-up9:30 am – Prayer & Reflections
10:00 am – 5K Run/Walk10:30 am – Kids Fun Run
12:30 pm – Awards1:00 pm – Music & Food
Results:Published in the Dixie County Times & Dixie County Advocate newspaper.
Pre-Race Packet First Baptist Church Cross City, Florida * 16024 SE Hwy 19* Cross City, Florida32628
Pick-up:Friday, June 4, 2010 from 4:00 pm – 7:00 pm
For information contact: Denise Williams-Butler (404) 423-4159 or or Sgt. Claude Hart
ATTENTION: waiver must be signed. If under 18 years of age, applicant must have signature of parent or guardian in addition to his/her own. Illegible or incomplete entries will not be accepted. No refunds. Race will be held rain or shine. Bicycles, skateboards, rollerskates, inline skates and other wheeled conveyances, and animals are not permitted due to insurance considerations.
Please cut off the bottom of the registration form and mail with entry fee to: Chad Reed Memorial 5K * P.O. Box 897Cross City, Florida32628
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2010 Captain Chad Reed Memorial 5K Run/Walk & 1 Mile Kid’s Fun Run Circle One: 5K Runner 5K Walker 1 Mile Fun Run
Name:______Age:______Birthdate: / / Circle Gender: M F
Address:______City:______State:______Zip:______
Phone:______Email:______
Shirt Size Circle One: YS YM YL YXL S M L XL 2XL 3XL
Waiver: Entry is invalid if not signed. In consideration of the acceptance of this registration entry. I the undersigned, as the entrant and/or parent/legal guardian of all minor children named on this registration entry, waive any and all claims for myself, my minor child or ward, heirs and successors and assume full and complete responsibility for any injury or accident, which may occur during my/our participation in the event or while I am on the premises of the event. I hereby release and hold harmless The Captain Chad Reed Memorial Committee, volunteers, sponsors, municipalities, promoters and all other persons and entities associated with the event, or their agents or employees or otherwise. I will not enter or participate unless medically and properly trained. I assume the risk associated with this event, included but not limited to fall, contact with participants, the effects or weather, including heat and humidity, the conditions of the road, all such risk being known. I further grant my permission to use any photographs, videotapes, or other record of this event. T-shirt size is not guaranteed. I understand that all entries are final with no refunds. I have read the forgoing and certify my agreement by this signature, and my parent’s/guardian’s if under 18.
______
Signature or participant DateSignature Parent/Guardian (if under 18) Date