More Information Contact:

Laura Koonts DCEF Administrative Director Office Cell #: (336) 905-0976 Email: www.dcefnc.org ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ How to register: Online registration runs July 1, 2016 - September 28, 2016 at Sportoften.com or by completing and returning the signed Registration form with payment. On-site registration (event day) begins at 7:30 a.m. in front of DCCC–Thomasville,NC, Mendenhall Bldg. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ REGISTRATION FORM Mail Registration and Checks Payable to: Davidson County Education Foundation (DCEF) ‘Run Friends Run’ - 5K Walk/Run P.O. Box 444, Lexington, NC 27293 336.905.0976

PRINT: First______MI____Last______Birthdate______Age Race Day______Sex: M F

Address: ______City______State______Zip______

Email Address______Home Telephone ( ) ______

Emergency Contact Name______Emergency Phone Number ( ) ______

Registration Fee enclosed: $______All donations to DCEF are greatly appreciated: $______

REGISTRATION FEES: (Please make checks payable to: DCEF) Students: $20.00 - thru Day of Event

Adults: $25.00 - thru September 30, 2016 Adults: $30.00 - Day of Event

Team: (5+) $20.00 - thru September 30, 2016

$30.00 - Day of Event

TEAM NAME: ______

Dry Fit T-shirts are only guaranteed if registered by September 21, 2016 for Students and Adults.

Youth T-Shirt Size: XS S M L Adult T-Shirt Size: XS S M L XL XXL

Waiver: As an entrant in the ‘Run-Friends-Run’, I assume complete responsibility for injury to me or damage to property, which may occur during the event or while I am on the premises of the event. I hereby release and hold harmless the Davidson County Education Foundation,, Davidson County Community College, Vac N Dash Timing Company, sponsors, volunteers, and all other persons or groups associated with the event from any and all liability associated with this event or otherwise. The terms hereof serve forever as a release and assumption of risk for my heirs, estate, executor, administrator, assignees, and for all members of my family. Children under the age of twelve (12) must be accompanied by an adult. I grant permission for any and all of the foregoing to use any photographs, videotapes, or recordings or any other record of this event for any purpose whatsoever.

Signature______Date______

Signature______Date______(Parent’s signature required if participant is under 18 years of age.)

Name: ______has my permission to pick up my Participant’s Packet on Friday, September 30, 2016, DCCC, 3:30-6:00 pm.