5k Run/Walk to End Dementia
Saturday, October 15, 2016
10:00 am Run 10:15 am Walk
Race Location:Bell Tower Residence, 1500 O’Day St, Merrill, WI.
Registration begins at 9am in Assisi Hall
Course Description:5k run is slightly hilly. Start at Assisi Hall at Bell Tower Residence and follow signs through Park Lane Manor neighborhood and then cross Highway K and go south to the Journey Church. Turn around and go north on Highway K until you reach the bridge over the Wisconsin River. Cross the highway before the bridge and go down the path that follows the river east. Continue along the river until you reach Riverside Park. Follow the road up the hill and back to Assisi Hall.
The walk has four different routes ranging from .35 miles to 3.2 miles and allows people of all fitness levels to participate, including those using walkers and wheelchairs.Walkers will not be chip timed.
5k Run awards: Fastest three women/fastest three men/first place in age groups – (12 and under, 13 – 15,
16 – 19, 20 – 29, 30 – 39, 40 – 49, 50 – 59, 60 – 69, 70 and over)
5k entry cost information: $30 with T-shirt {20 without}, $30 after October 5, 2016 and the day of the race-
not-shirt.
Other Information: Results by Tortoise & Hare Race Management, LLC.
Make Checks to:Bell Tower Residence. And mail to: 1500 O’Day St, Merrill, WI 54452
Contact: Linda Schmidt at 715-536-5575, fax 715-536-1765, email:
Website: Race forms are also available online at
Results will be posted.
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5k RUN TO END DEMENTIA ENTRY FORM 10/15/2016 PLEASE PRINT LEGIBLY
Name______Sex____Age______
Address ______
City, State Zip ______
Phone ______E-mail ______
SHIRT SIZE (circle One) SM M L XL NONE
Name of affiliation of Club or Team ______
Waiver on next page (MUST BE SIGNED AND SUBMITTED)
In consideration of your accepting this entry I, the below signed, intending to be legally bound, for myself, my heirs,my executors and administrators, waive and release and any all rights and claims for damages I may have against the race, and sponsors and their representatives, successors and assigns for any and all injuries suffered by me in said event. I attest that I will participate in this event as a footrace, that I am physically fit and sufficiently trained for the completion of this event. Furthermore, I hereby grant full permission to use my name and likeliness, as well as any photographs and any record of this event in which I may appear for any legitimate purpose, including advertising and promotion.
Signature______Date______
Parent or Guardian if under 18______
FORM POSTED AT belltowerresidence.org