registration form - Union County Public Schools

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Run Like a Brave 5K
March 23rd, 2013 -- 9am
Elkwood Golf Course in Union County Fairgrounds, Sturgis
Preregistration Entry Fee $20 / Race Day Entry Fee $25
Name:__________________________________________ Address:________________________________________________________
City:______________________________ State: _______ Zip: _____________ Phone: ( ___
)________________________________
Email: ___________________________________________Date of Birth: ____/____/____ Age: _______ Gender: ____M ____ F
Team/School Name: _______________________________________
Teams must enter a minimum of five runners. Team members must preregister.
Select Race:
5K Run
School age child ___ (free if preregistered)
UCPS Staff ___ ($10 if preregistered)
Mail Entry Form & Payment
by 03/08/13 to :
1 Mile Fun Run/Walk
Shirt Size: Circle one
Youth XS
Adult
S
S
M
M
L
L
United Community Bank
c/o Jim Peak
500 North Morgan St.
Morganfield, KY 42437
No shirt -- please donate cost of shirt to event proceeds.
XL
XXL ($3extra fee)
XXXL ($3 extra fee)
RELEASE OF RESPONSIBILITY (MUST BE SIGNED BY PARTICIPANT OR BY PARENT/GUADIAN IF UNDER 18)
Runners must be careful to register and run under their proper name, sex, and age division to avoid disqualification. In consideration of accepting my entry, I , intending to be legally
bound, do hereby for myself, my heirs, my executors, and administrators, do waive and release forever, any and all rights and claims for damages I may accrue against all persons and
agencies, namely Union County Public Schools, Union County Cross Country Boosters, and Union County YMCA, all of its agencies and any Run Like a Brave Race sponsors involved
with promoting the race as listed by their successors, representatives, and assigns for any and all injuries suffered by me while traveling to and from and while participating in any Run
Like a Brave competition on March 23, 2013 in Union County, Kentucky or during any run mentoring sessions affiliated with the Run Like a Brave races. I further state that I am in proper
physical condition to participate in this event. I also release publication rights to photographs taken of me during any Run Like a Brave event for purposes of publicity for this and future
Run Like a Brave events.
_____________________________________________________________
Signature
________________
Date
______________________________________________________
Parent Signature (if under 18)
Run Like a Brave 5K
March 23 – Union County Fair Grounds, Sturgis
AWARDS
All Union County school age children who preregister and complete either race receive a T-shirt.
5K Awards:
*Trophies for Over All Male & Female Winners
*Medals for 1st, 2nd, 3rd place finishers in
each age group for males & females
*Trophy (and bragging rights) for first place team
(Combined finish place of first 5 runners)
1 Mile Fun Run/Walk: Medals for Over All Male & Female Winners
9 & Under
10-12
13-15
16-18
19-24
The School who has the most team members finish the race wins a plaque.
Run Like a Brave Again
May 25, 2013– Run For the Roses (Morganfield Park)
25-29
30-39
40-49
50-59
60 +
Run Like a Brave 5K
March 23rd, 2013 -- 9am
Elkwood Golf Course in Union County Fairgrounds
Preregistration Entry Fee $20 / Race Day Entry Fee $25
Organized by
Union County Cross Country Braves
A Big Brave Whoop to Our Sponsors
Methodist Hospital Union County
River View Coal, LLC
Union County YMCA
United Community Bank
Run Like a Brave Again
May 25, 2013– Run For the Roses (Morganfield Park)
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