WHEN: May 15th, 2010
REGISTRATION: 7:30AM-8:20AM
RACE START: 8:30AM
WHERE: LINCOLN HIGH SCHOOL PARKING LOT
RYAN AVE AND SACKET ST.
PRICE: Eighteen ($18) Dollars before May 12, 2010 and
Twenty ($20) Dollars on Race Day made payable to the Mayfair Business Association
3530 Cottman Ave., Phila., PA 19149
ALL PROCEEDS BENEFIT THE HERO THRILL SHOW
FOR THE EDUCATION OF THE SURVIVORS OF FALLEN POLICE AND FIRE AS WELL AS THE MAYFAIR MEMORIAL PLAYGROUND
"This event is sanctioned by USA Track & Field."
5k – Entry Form
Name ____________________________________________ Age______
Address (Street) ____________________________
City _______________________ State ____ Zip Code ____________
Phone (_____) ______________ Email _________________________
Emergency Contact (Name and Phone)________________________________________
Are you a Philadelphia Firefighter or Police Officer? (Y/N)
I will participate in the Run ____ Walk ____
Liability Waiver Must Be Signed
I know that participating in a 5K RACE is a potentially hazardous activity. I should not enter unless I am medically able and properly trained. I agree to abide by any decision of the race officials relative to my ability to complete this race safely. I assume all risks associated with running in this event, including, but not limited to falls, contact with other participants, the effects of weather, including high heat and humidity, traffic and the conditions of the road, all 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, for myself and anyone entitled to act on my behalf, waive and release the Mayfair Business Association, Civic Association or Community Development Corporation, their representatives and their successors and all race-day volunteers from all claims or liabilities of any kind arising out of my participation in this event.
In consideration of the safety of all participants, I understand that no baby joggers or strollers, headphones, animals on a leash, skateboards, roller blades or bicycles are allowed on the course. In addition, I understand that if the race is cancelled by circumstances beyond the control of the organizers, my entry fee will not be refunded.
SIGNATURE ________________________________________________________ Date _____
(Parent or Guardian if under 18)___________________________________________________
