REGISTRATION FORM
MAY 18th at 10:30 a.m.
Prairie Oaks Metro Park
4275 Amity Road
Hilliard, Ohio 43026
Taylor Pierron started running before he could walk. He loved hunting, fishing, and being outdoors so much he received his degree in
landscaping. He was selfless and always there to lend a hand to those in need. Taylor lost his life in a terrible accident in November,
2012. This fundraiser will enable Taylor's legacy and spirit to live on through charitable works. He is truly missed by his family and
friends. Please honor his life with us.
All proceeds go to “Bridges of Saint Mark”,
a ministry of St. Mark Catholic Church, helping Rach Suc Mission Church and its community in Can Tho,
Vietnam in in the form of projects. Our intentions are to set certain projects as goals and work to fulfill them. Our recent efforts have focused more on
water filtration and purification. As we grow, we hope to help in other ways; such as, playgrounds for children, transportation, facilities for the many
Vietnamese doctors and teachers who volunteer on a weekly and sometimes on a daily basis, and whatever the needs might be.
Registration Fee is $30.00 Checks payable to: Bridges of St. Mark
Mail In Registration should go to: BRIDGES OF SAINT MARK - 432 Gay Street, Lancaster, Ohio 43130--Attn: Theresa Brunney
Forms online at: http://www.bridgesofsaintmark.org/
Age Group to be entering:
T-Shirt Size:
SMALL
0-10 yrs
MED
10-19 yrs
LARGE
20-29 yrs
30-49 yrs
50+yrs
XLARGE
Course is a combination of rolling paths.
All pre-registered runners are guaranteed a T-Shirt.
Awards : Prizes for top male and female in each age category. Awards will be given out after race is completed back at the registration shelter.
Water will be available at approximately 2 K marker of the 5 K course. Post-race snacks will be provided.
Last Name: _____________________________________First Name: __________________________________________
Address__________________________________City__________________State ____________Zip_________________
Phone: _________________________Email Address:_______________________________________________________
Race Waiver: I know that running/walking in a race is potentially a hazardous activity. I should not enter and run in this race unless I am medically able and properly
trained. I assume all risks associated with running/walking in this race, including, but not limited to: falls, contact with other participants, the effects of weather,
including low temperatures and/or precipitation, the conditions of the course; all such risks being known and appreciated by me. Having read this waiver and
knowing these facts, and in consideration of your acceptance of my application, I, for myself and anyone entitled to act on my behalf, waive and release The Bridges
of St. Mark, Robert and Beth Pierron, the City of Columbus, Columbus Parks and Recreation, Columbus Metro Parks and all sponsors, their representatives and
successors from all claims or liabilities of any kind arising out of my participation in the race even though that liability may arise out of negligence or carelessness on
the part of the persons named in this waiver. I also grant my permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other
record of this event for any legitimate purpose.
Signature: ___________________________________________________________________