Come and run with us!
Saturday, November 2, 2013
Registration begins at 8:00 AM; Race begins at 9:00 AM
The complex of the Polk County Sheriff’s Office
Southwest District Command, Polk State College
Campus, and Fort Fraser Trail
4120 US Highway 98 South; Lakeland, Florida 33801
EVENT AND COURSE INFORMATION
We welcome all ages and experience levels of runners, joggers, and walkers.
The 5K (3.1 miles) course is paved and begins and ends at the entrance of Polk County Sheriff’s Office Southwest District
Command and Polk State College.
Additional activities available for your family and friends during the event: Polk County Sheriff’s Office Special Operations vehicles
on display, canine meet and greet and more!
Restrooms will be available for public use during the event.
REGISTRATION AND ENTRY FEE INFORMATION
For each participant, please complete the entry form and signed waiver. If participant is 17 years of age or younger, parent or
guardian must sign the waiver on their behalf. Please include the correct monetary donation based on registration date and age.
Registration donations are non-refundable. United Way donation receipts will be provided on race day.
On or before Wednesday, October 23, 2013:
- 18 years of age and older: $25 Donation
- 17 years of age and younger: $20 Donation
Thursday, October 24, 2013 – Saturday, November 2, 2013
- All ages: $30 Donation
ONLINE REGISTRATION AND PAYMENT IS
AVAILABLE THROUGH ACTIVE.COM AT:
http://www.active.com/running/lakelandfl/walking-event---judd-jog-2013
T-SHIRT INFORMATION
Participants who complete their registration prior to Wednesday, October 23, 2013 will receive a t-shirt on event day. Those who
complete registration between Thursday, October 24, 2013 through Saturday, November 2, 2013 are not guaranteed a t-shirt on
event day. Participants may be required to arrange for pick-up of the t-shirt following the event.
THE JUDD JOG BENEFITING THE UNITED WAY
SATURDAY, NOVEMBER 2, 2013
POLK COUNTY SHERIFF’S OFFICE SOUTHWEST DISTRICT COMMAND/POLK STATE COLLEGE
AWARD INFORMATION
First place male and female finishers in the following categories will be rewarded:
- Youth: up to 17 years of age
- Young Adult: 18 – 29 years of age
Adult:
30
–
39
years
of
age
- Adult:
– 49 awards:
years of age
FFirst place finishers in the following categories
will 40
receive
- Adult: 50 – 59 years of age
- Adult: 60 – 69 years of age
- Adult: 70+ years of age
ENTRY FORM
NAME:
__________________________________________________
For participants who are 17 years of age or younger, please indicate their parent or guardian’s name:
___________ ___
AGE (on race day): ______________________________________
GENDER (please circle one):
Male
Female
ADDRESS: _____________________________________________________________________________________________________________________
CITY: ____________________________________________________________________ STATE: ___________________ ZIP: ______________________
PHONE NUMBER: ____________________________________________ CELL NUMBER: _________________________________________________
EMAIL ADDRESS: ______________________________________________________________________________________________________________
* The information you provide will not be sold or distributed to another party.
T-SHIRT SIZE (please circle one): Youth Sizes: S M L
DONATION METHOD: (please circle one):
Cash
Adult Sizes: S M L XL XXL XXXL
Check
Money Order
* Please make checks payable to the Polk County Sheriff’s Office/Judd Jog
United Way Donation Receipt will be provided on race day.
ONLINE REGISTRATION AND PAYMENT IS AVAILABLE THROUGH ACTIVE.COM AT:
http://www.active.com/running/lakeland-fl/walking-event---judd-jog-2013
WAIVER
With this entry, I understand that a 5k run/walk requires physical and psychological activity and there is a possibility that the
above participant and their supporting spectators could be injured during the event. The participant and their guardians waive
their right to hold The Polk County Sheriff’s Office, The United Way, The Cities of Winter Haven, Lakeland, and Bartow, The Board
of County Commissioners of Polk County, Polk State College and their employees, volunteers, and sponsors, responsible for any
and all injuries or damages that may occur physically or psychologically as a result of participating in The Judd Jog Benefiting The
United Way.
I also understand that photographs and video footage maybe taken during this event and that the participants’ and spectators’
images maybe reproduced in association with this event.
SIGNATURE: _____________________________________________________________________________________ DATE: _____________________
(if participant is 17 years of age or younger, parent or guardian must sign on their behalf)
Please submit completed entry forms, waivers, and donations to:
Polk County Sheriff’s Office; Attention: Human Resources Division; 1891 Jim Keene Boulevard; Winter Haven, Florida 33880
To submit electronically, please visit: http://www.active.com/running/lakeland-fl/walking-event---judd-jog-2013
Questions? Please contact the PCSO’s Human Resources Division at 863.298.6440.
THE JUDD JOG BENEFITING THE UNITED WAY
SATURDAY, NOVEMBER 2, 2013
POLK COUNTY SHERIFF’S OFFICE SOUTHWEST DISTRICT COMMAND/POLK STATE COLLEGE