Race Application
The Tilted Tartan Turkey Trot
November 2nd 2013 9am
Springfield Illinois Centennial Park to Tilted Kilt
Benefiting St Andrew’s World Tour and Breast Cancer
Entry fee $30
due by October 26th
Circle one
5K road race
Male
under 18
Circle one Shirt size Regular T-shirt
1 mile run/walk
Child
S
M
L
Female
Adult
S
M
L
Circle one Age
19 – 35
36 – 54
XL
XXL
XXXL
$1 extra XX $2 extra XXX
Circle one Shirt type
Long sleeve T-shirt
Dry fit T-shirt
$5 extra fee
55 & over
Name (please print) (separate entry form per person)
Address
city
Phone number
state
zip code
Email address
Waver (read before signing)
I know that participation in this event is a potentially hazardous activity. I will not enter and participate unless I am medically able and not
properly trained. I agree to abide by any decision of any race official as to my ability to safely complete the event. I assume all risks associated
with this event, including but not limited to falls, contact with other participants, and effects of weather including high heat and humidity,
traffic and the condition of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in
consideration for your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release The St. Andrew’s Society of
Central Illinois, The Tilted Kilt, The City of Springfield, race officials volunteers and all sponsors from all claims or liabilities of any kind arising out
of my participation in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings or any other
record of this event for any legitimate purposes.
Signature of runner/walker (or parent if under 18years of age)
Race begins at Centennial Park, Springfield …………and ends at Tilted Kilt
Packet pickup at Tilted Kilt Friday November 1st 5:00 – 7:00pm
Wrap up party immediately following race at Tilted Kilt
Shuttle bus provided between Tilted Kilt and Park
www.usatf.org/routes/view.asp?rID=524292
Make check payable to:
St. Andrew’s Trip Fund
Mail to : Leigh Ann Wallace10343 Whitescrossing Avenue
Oakford Il 62673
Or drop off at Tilted Kilt
Or enter and pay online at:
http:// www.central-illinois-standrewsociety.com/