Run for Teddy 5K

Lake Road /Harry Wright Lake
Whiting, NJ US 08759

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Run for Teddy 5K

 

EVENT OVERVIEW

 

Date: Saturday, May 4, 2013

Time: 5K Run begins at 8:30 am; 1 mile fun run begins at 9:30am;

 Same?day registration/ packet pick up begins at 7:00 am

Location: Harry Wright Lake, Whiting, New Jersey

Participation Fee: $20 includes a free T-shirt! $25.00 the day of the race

 

 

REGISTRATION INFORMATION

Will you be participating in the 5k______ or 1 mile fun run_______

Name: ____________________________________________________

Address: _______________________________________________________

Phone Number:_____________________

Email: ___________________________

 

Adult T?Shirt Size (circle one):    S    M   L    XL

 

Registration form and check due by April 5, 2013 in order to guarantee t-shirt by event!

 

Please sign the waiver statement below:

I, the undersigned, in consideration of acceptance of the entry and registration as participant in The Run for Teddy 5K, waive any and all claims which I and my heirs or assigns may now or hereafter have against The Run for Teddy 5k, its members, Manchester Township, and all officials, volunteers and sponsors of The Run for Teddy 5K, which may indirectly or directly result from my participation in The Run for Teddy 5K. I further warrant and represent that I am in proper physical condition to participate in The Run for Teddy 5K and am not participating in this event against physician's advice nor am I taking medications which would impair my health or ability to participate in The Run for Teddy 5K. Further, I grant permission to all of the foregoing to use any photographs, motion pictures, recordings or any other record of this event for legitimate purposes.

 

Signature (parent or guardian if under 18) ____________________________________________ Date ____________________

Please complete the above information and send this form, along with your check made payable to The Teddy Adams Foundation to:

 

Crystle Skinner

c/o The Teddy Adams Foundation

1621 Pennsylvania Avenue

Whiting, NJ 08759

 

Please make a copy of this form for your records!

Questions? Contact Crystle Skinner at CrystleSkinner@yahoo.com