1. education
2. high school

Centerville Lions Club 4th Annual
5K RUN/WALK
“Moving our feet to help those we meet”
The Centerville Lions Club is a co-ed service organization providing assistance in different ways.
Examples: we award scholarships to CHS seniors, assist in Flag Day ceremonies for Kindergartners,
collect used eyewear and assist individuals with eye glasses. We look forward to greeting new members
and identifying new projects. Check us out on www.CentervilleLions.org
When: Sat. July 25, 2015 @ 8:30 a.m. Check-In between 7:30 – 8:15 a.m.
Where: “The Pond” Shelter at Oak Grove Park in Washington Township,
1790 E. Social Row Road, Centerville
RAIN OR SHINE – NO REFUNDS
Registration Fee includes unisex shirt (if received on or
before July 10)
After July 10, Registration Fee (no shirt)
Total Payment Amount: _________________
Under
Age 13
$15
Enter
Quantity
Age 13 and
Older
$20
$20
Enter
Quantity
$25
Register and pay online at www.Speedy-Feet.com
Checks should be made payable to “Centerville Lions Club” and mailed to
Centerville Lions c/o John Kirsch 1200 Green Timber Trl, Centerville, OH 45458
First Name:________________________________________ Last Name________________________________________ M________F________
Address:______________________________________________________________________________________________________________________
City: _______________________________________________ State: ________ Zip: _______________Phone: (_____) _______________________
Email: _______________________________________________
Shirts are Unisex
Circle One Size Youth: S M L
Date of Birth: ______________
Age: ____
Adult: S M L XL 1X 2X 3X
REQUIRED: EMERGENCY CONTACT for RUN/WALK: _______________________________________
(print name)
_________________________________
(emergency phone)
I, myself, my heirs, executors & administrators, hereby waive and release any and all rights and claims for damages I
may have against Centerville Lions Club and race sponsors, their respective agents, Centerville-Washington Park
District, Race Board, employees and volunteers for any or all injuries which may be suffered in connection with
participation in this event. I also hereby attest and certify that I am physically fit to compete in this race and am
aware of traffic hazards.
Name/Relationship___________________________________________________________Date:________________________________
If under 18, MUST BE SIGNED BY A PARENT OR LEGAL GUARDIAN
Centerville Lions 5K Run/Walk
Saturday, July 25, 2015
Race Information
Location: “The Pond” Shelter at Oak Grove Park in Washington Township, 1790 E. Social Row
Road, Centerville 45458
Race Check-in: Begins at 7:30 a.m. and ends at 8:15 a.m. Race begins promptly at 8:30 a.m. rain or
shine; no refunds. Payment on day of race can be made via cash or check only.
Directions: From the intersection of State Route 48 and Social Row Road, head east on Social Row Road
approximately one mile. Meet at The Pond shelter.
Parking: Various lots at the park.
Course: Two laps around the park perimeter on a paved path.
Awards: Top male and top female winners, along with age group winners. Two awards or less, per age group,
depending on the number of entrants.
Male: 12 and under; 13-19; 20-29; 30-39; 40-49; 50-59; 60-69; 70+
Female: 12 and under; 13-19; 20-29; 30-39; 40-49; 50-59; 60-69; 70+
Door Prize Drawings: Racers are also eligible for door prizes; must be present to win.
Fees: Under age 13, entry fee is $15 (with shirt) if registered on or before July 10. Under age 13, after July 10 (and
on race day) registration is $20 (no shirt). Age 13 and older, entry fee is $20 (with shirt) if registered on or before
July 10. Age 13 and older, after July 10 (and on race day) registration is $25 (no shirt).
Shirts: Shirts are available to racers who register on or before July 10, 2015.
Questions: Event Director is Ed Thornhill, 937-885-2109 or [email protected]