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Jersey Shore Running Club &
Long Branch PBA Local #10
Present the 24th running of the Annual Spring Run
Celtic Tribute 5K
to benefit PBA Local 10 Scholarship Fund in Memory of our Fallen Officers
and FACES (Finding a Cure for Epilepsy and Seizures)
5K Race with JSRC Kids’ Races
www.JSRC.org or
CelticTribute5k.com
Sat. April 4, 2015 - Long Branch, NJ
TIME: 5K Race - 11:00 AM
Kid's Races - 11:45 AM
LOCATION: Great Lawn/Promenade, Whitman Terr & McKinley St, Long Branch, GSP Exit 105, Take Rte 36, Turn South on Ocean Blvd
RACE DAY REGISTRATION: Starting 9:30 am Shirts Guaranteed to Pre-reg only.
ENTRY FEE: $22.00 by March 28, $25.00 after March 28, ($20.00 -JSRC Members before March 28 only)
SPECIAL RATE RACE ENTRY with MEMBERSHIP TO JSRC (COMBO): $35.00 (before March 28)
Kid's Race Fee $8.00 by March 28- $10.00 Post (Age 12 and under)
Pre-Race Packet Pickup
RANDOM PRIZE DRAWINGS including GRAND PRIZE
& Registration
Computerized Scoring - AWARDS: Top 3 plus 5-year age groups, plus: Top Cop Division (Top 5 M/F),
Friday, April 3
5:30 to 7 pm
Largest Law Enforcement Group and Best Represented PBA Local
Celtic Cottage
GREAT Post Race Pasta Party at The Celtic Cottage
608 2nd Ave, Long Branch
INFORMATION: Hotline 732 -571-2162, [email protected] Register online at http://www.CelticTribute5K.com
Return Completed Form with check made out to JSRC, Mail to: Celtic Tribute 5K, PO Box 46, Long Branch, NJ 07740
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Last Name
First Name
Age
Sex (M or F)
h
Address
City
Phone
Circle Event
State
Zip
EMail
5K Run
JSRC Member (circle)
Circle One Shirt Size:
Kid’sRaces
yes or
Law Enforcement Officer (circle)
YM YL
Kid’s Race
S M L XL XXL
Adult
no
yes or
no
Law Enforcement Agency _________________ (Pre-Registered Only)
PBA Members Local PBA/#______MUST BE MEMBER (Pre-Reg. Only)
Registration Fee only
Combo Pre-Reg & JSRC membership (only $35)
Optional / Additional Donations
Total
$______
$______
$______
$______
I know that running a road race is a potentially hazardous activity and that I should not enter and run unless I am medically able and properly trained. I agree to abide by any race official relative to my
ability to safely complete the run. I assume all risks associated with running this event including but not limited to falls, contact with other participants, the effect of the weather, including low or high
temperatures and/or humidity, traffic and the conditions of the course, all such risks being known and appreciated by me. Hav ing read this waiver and knowing these facts and in consideration of your
accepting my entry, I, myself and anyone entitled to act on my behalf, waive and release the Jersey Shore Running Club, its Officers, Members and race volunteers, the City of Long Branch and its
Departments and employees, the RRCA, and all sponsors, their representatives, employees and successors from any and all claims and liabilities of any kind
For Official Use
arising out of my participation in this event or carelessness of the persons named in this waiver. Further, I grant to all of the forgoing to use any photographs,
motion pictures, recordings or any other record of this event for legitimate purposes.
Signature______________________________________Date__________
Participant signature (or parent/ guardian if under 18). Must be a signature here.