Fit & Fun 5K Run & Walk
A family friendly 5K race & fitness walk to raise funds for school enrichment programs.

Saturday May 29, 2010

Newfane Elementary School
14 School St. (Off Rt. 30)
Newfane, VT 05345

5K - $15 Individual / $25 Family
Please fill out 1 application per person

Kids Run FREE (13 & Under)

Make check payable to: Newfane Elementary School PTO,

and mail to: Fit & Fun 5K Registration, PO Box 376, Newfane, VT 05345

 

Name :______________________________________ Circle   Individual   Family Entry
                                                                      Send all family entries together in 1 envelope

 

Circle Gender:   M    F   Age:______   Circle T-Shirt Size:   Youth:  S  M  L   Adult S  M  L  XL

 

Address :_______________________________________ Phone:______________________

 

City :_ ___________________State:___ Zip Code:______ Email:________________________

 

Circle Event:  1/2 Mile Fun Run  5K Runner  5K Walker (Circle runner if you plan to run ANY portion)

 

I know that running is a potentially hazardous activity. I should not enter or run/walk this event unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run/walk. I assume all risks associated with running in this race including, but not limited to, falls, contact with other participants, the effects of weather, including high heat and/or humidity, the conditions of the road and traffic on the course, all such risks being known and appreciated by me. Having read this waiver and knowing these facts, and in consideration of your acceptance of my application, I, for myself and anyone entitled to act on my behalf, waive and release the Newfane Elemntary School; 3C Race Productions LLC; the town of Newfane, Vermont; and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. All fees are nonrefundable.

 

____________________________________  ________  __________________________________
Signature                             Date      Parent's Signature if under 18