5th-Annual-Race-application

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5th Annual
Kerry Blue Hustle
5K Race/Walk &
Half-mile Kids’ Dash
May 16, 2015
Date/Time: Saturday, May 16, 2015: 9:00 am 5K Run and 10:00 am Half-mile Kids’ Dash
Start/Finish: 10-12 Church Street, Glens Falls at St. Mary’s-St. Alphonsus Regional Catholic School
Course: Starting on Church Street, including a segment of the bike path, looping around East Field with some longer
straightaways. Mostly flat and fast! And… a big hit with both the young and the young-at-heart: three water stops!
Day of Race Registration: 7:30am-8:45am SMSA School Cafeteria
Register: Go to www.smsaschool.org to print and mail your application and payment. Or go to www.active.com for
online registration and pay with credit card. Email questions to: kerrybluehustle5k@gmail.com .
Entry: $20 in advance paid by check, or $20 online (by April 15th for shirt guaranteed). Race Day $25 (shirt if available.)
Awards: Top 3 overall, M/F, top 3 finishers M/F in 5 year age brackets - incl. 9 & under, 10-12, 70+.
Award given to fastest M/F SMSA Alumni time.
Kids’ Half-mile Dash: Free! 1/2 Mile Run for children. In lieu of entry fee, a donation to the St. Mary’s food pantry is
appreciated. Ribbons to all participants.
Directions to SMSA School: Start/Finish at SMSA. From the famous Glens Falls Roundabout, take Ridge St. North to a
right on Maple St., Church St. is on the right. (No Parking will be available on Church St.) Parking is available on Maple,
Pearl and Warren Streets, or behind the St. Mary’s Church. Benefits: This fund-raising event celebrates SMSA’s
volunteerism and community spirit, as well as our connection to East Field and the Greater Glens Falls Community as a
whole. All proceeds will benefit SMSA and St. Mary’s Food Pantry.
_________________________________________________________________________________________________
Mail Entry to:
Kerry Blue Hustle, c/o Babette Donlon, 10-12 Church Street, Glens Falls, NY 12801
Kerry Blue Hustle Waiver: I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained to complete the event. I assume all
risks associated with running this race, including, but not limited to falls, contact with other participants, runners, bikers, cars, horses and other animals, the effects of weather, including heat or cold and
precipitation, traffic, and the conditions of the trails and roads, such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my
entry, I myself and anyone for whom I am entitled to act, waive, release, and will hold harmless the race organizer, SMSA, all other sponsors and property owners, and all the agents, employees, officers,
directors and volunteers working for those entities from all claims and liabilities of any kind arising out of or related to my participation in this race. I understand that headphones, Roller Skates and
Dogs are NOT allowed in this race.
First Name____________________________Last Name__________________________
Street Address____________________________________________________Phone___________________________________
City_____________________________________State_______________________________________Zip____________________
email address______________________________________________________________________________________________
age on race day_______________Gender: M F
SMSA Alumni?(circle) Yes No
If yes, class of _____________
Participant Signature (parent if under 18)______________________________________________ Date_______________
T-shirt (circle one): Women's t-shirt: WS WM WL WXL, Men's t-shirt: MS MM ML MXL M2XL , Youth's t-shirt: YM YL
NOTE: Separate entry forms/ waivers must be completed for EACH participant.
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