NEW YORK STATE FRATERNAL ORDER OF POLICE
ISLIP LAW ENFORCEMENT LODGE # 862
PRESENTS
The First Long Island MacArthur Airport 5K Run for Veterans
Saturday, June 5, 2010 9:00 AM
Long Island MacArthur Airport
Ronkonkoma, NY
Show your support and appreciation for our local veterans. Instead of the usual roadways, we will be running and walking on the airport taxiways and runways.
At points it will seem as if you can reach out and touch the 737’s and other aircraft taking off and landing.
Early Registration fee $25.00 Day of race registration fee $30.00
T-shirts limited to the first 500 pre-registered participants. T-shirts limited while supply lasts on race day
Race time and results will be compiled by Finish Line Road Technicians
APPLICATION (please print)
Name______Age______Sex___
Street Name______
City/State______Zip Code______
Phone______Email______
All pre-registrants will be emailed information regarding early check in and race packet pick up. For additional information contact the race committee at or call 631 615-9365. Registration available online at :
http://www.active.com/running/ronkonkoma-ny/long-island-macarthur-airport-5k-run-for-veterans-2010
RACE: (circle one) 5K Run 5K Walk
T-SHIRT SIZE (circle one) Small Medium Large Ex-large
Make checks payable to: NYSFOP LODGE 862
Mail to PO BOX 1101
Ronkonkoma, NY 11779
Waiver: In consideration of the acceptance of my entry, I do herby, for myself, my heirs, executors, and administrators, waive, release and forever discharge any and all rights and claims for damages which I may have or which may hereafter accrue to me while traveling to and from or participating in The First Long Island MacArthur Airport 5K Run for Veterans, against the New York State Fraternal Order of Police, The New York State Fraternal Order of Police Islip Law Enforcement Lodge 862, The Town of Islip, Long Island MacArthur Airport and their respective police, fire and emergency agencies, or their respective officers, agents, representatives, or successors along with any sponsors and volunteers of said event, as a result of my participation in said run. I also give permission for the free use of my name, picture or likeness in any account for the promotion of this race. I herby attest and verify that I have full knowledge of the risks involved in participating in this event and that I am physically fit and sufficiently trained to participate and complete this event, and that my physical condition has been verified by a licensed medical doctor. I have read the above statement, I understand it, and my signature confirms its full acceptance.
Date:______Signature:______
Signature of Parent/Guardian ( if participant is under 18)______