BEFORE 8/7 $25 AFTER 8/7 $30 Kids 12 and under are free (no t-shirt or chip) Kids 12 and under $15 (includes t-shirt and chip)must register Name Address 1701 Westchester Drive Suite, 850 High Point, NC 27262 REGISTRATION 3rd Annual Cornerstone 5K Run/Walk City State Zip Phone Email Date of Birth ❏ Male ❏ Female Shirt Size: ❏ S ❏ M ❏ L ❏ XL ❏ XXL Youth Size: ❏ S ❏ M ❏ L ❏ Cash Method of Payment: ❏ Check (Payable to Cornerstone Health Care, PA) No refunds– please consider this a charity donation in the event of withdrawal Mail Waiver, Registration and Fee to: Cornerstone Health Care Attention: Human Resources 1701 Westchester Drive Suite 850 High Point, NC 27262 OR Register online* at: http://cornerstone5K.com/ (*$2.50 processing fee will be added if you register online) EVENT WILL BE HELD RAIN OR SHINE! Saturday, August 29, 2015 • 9a.m. West End Park 1701 Edgewood Drive High Point, NC 27262 Proceeds will benefit American Cancer Society’s Relay for Life PURPOSE OF EVENT The Cornerstone Cares 5K Run/Walk was established in 2013 to raise funds for the American Cancer Society’s Relay For Life and to promote wellness and active lifestyles. With your help, we aren’t just fighting one type of cancer– we’re fighting for every birthday threatened by every cancer in the community. 3rd Annual Cornerstone 5K Run/Walk COURSE MAP WAIVER AND RELEASE Race Waiver: I know that running/walking a road race is a potentially hazardous activity. I should not enter and run/walk unless I am medically able and properly trained. I assume all risks associated with running/walking in this race, including, but not limited to falls, contact with other participants, effects of weather including high heat/cold or humidity, traffic and the conditions of the road, all such risks being known and accepted by me. Having read this waiver and knowing these facts and in DATE/TIME/LOCATION consideration of your accepting my entry, I myself and anyone Saturday, August 29, 2015 • 9a.m. West End Park 1701 Edgewood Drive High Point, NC 27262 for whom I am entitled to act, waive, release, and will hold (Behind Cornerstone’s Administrative Office) ***Please park at First Wesleyan Church*** Turn at Coventry Road light (at Rite Aid) off Westchester Drive entities from all claims and liabilities of any kind arising out of harmless the City of High Point, Providence Place, Cornerstone Health Care, First Wesleyan Church, the race organizer, High Point Parks and Recreation and all sponsors and all the agents, employees, officers, directors and volunteers working for those or related to my participation in this race. I understand that event photographs will be taken on race day. I freely give my permission in this race. I understand that event photographs NO PETS PLEASE and images may be taken during this event and may be published without further communications or compensation to ENTRY FEE me. 5K Run/Walk: $25.00 BEFORE August 7 $30.00 AFTER August 7 I understand and agree to the waiver and release. Signed: ______________________Date: _________ (including same day registration) Entry fee includes a custom t-shirt, post race refreshments, awards and official race results. Mail Waiver, Registration and Fee to: Cornerstone Health Care (You will not receive a t-shirt if you register on or after August 7.) Attention: Human Resources 1701 Westchester Drive Suite 850 High Point, NC 27262 AWARDS Awards will be given to the top two finishers within their age group. Packet pick-up will be Thursday, August 27 from 5-6:30p.m. at 1701 Westchester Drive and on race day from 7:30 to 8:30a.m. Proceeds will benefit American Cancer Society’s Relay for Life OR Register online* at: http://cornerstone5K.com/ (*$2.50 processing fee will be added if you register online) Race Management by On The Mark Sports EVENT WILL BE HELD RAIN OR SHINE!