registration form - Finger Lakes Runners Club

 The 40th Annual Ithaca 5&10 + 5k! Sunday, September 13, 2015 The flat and fast Ithaca 5&10 course starts and finishes at Ithaca High School (1401 N. Cayuga St.) and runs through downtown Ithaca, residential, and park areas of the City. The 5 mile race is a single loop course, while the 10 mile race is a double loop. The second annual 5K run/walk on the same course will raise funds to support the Ithaca Youth Bureau. All three courses will be USATF certified. Water stations will be available. Traffic will be controlled by marshals. Family Fun Run is on sidewalk and grass areas. STARTING TIMES: 5K – 8:45 AM 5 mile -­‐ 9:15 AM 10 Mile -­‐ 9:30 AM Family Fun Run (approx. 1 Mile) -­‐ 8:30 AM ENTRY FEE: Preregistration: $15 for adults; $10 for ages 18 and under; mail in must be postmarked by Tue, September 8, 2015; FLRC members may deduct $2 from the preregistration fee. Race day registration is $25 for adults or $15 for 18 and under. There is no race day discount for FLRC members. Family Fun Run is free, but parents must sign a waiver. Add $20 to registration fees for a short-­‐sleeved 5&10 shirt (technical fabric). Longsleeve cotton shirts will be for sale at the race. ON-­‐LINE REGISTRATION: Link at http://fingerlakesrunners.org/ > Roads > Ithaca 5 & 10 (ends 10 AM, Wed. 9/9/15) ADVANCE PACKET PICKUP AND REGISTRATION: 12 PM -­‐ 7 PM on Friday, September 11, at Finger Lakes Running & Triathlon Company on the Ithaca Commons. RACE DAY REGISTRATION: from 7:30 – 8:45 AM on September 13 at Ithaca High School. RACE INFORMATION: See FLRC Website (http://fingerlakesrunners.org/ ) for all race information including course maps. Race director Alan Lockett can be contacted at [email protected]. The race directors reserve the right to reject any entry for any reason. Headsets are not allowed and you may be disqualified if used during the race. Strollers and pets are also prohibited. Cut on the dotted line and mail bottom part with check payable to FLRC (see fees above) to: 5&10, c/o Alan Lockett, 43 Ludlowville Rd., Lansing NY 14882. Mailed preregistrations must be postmarked by Tuesday 9/8; online preregistration ends 9/9. Bib number
Ithaca 5&10 Entry Form Select race: ___5K ___5 mi ___10 mi ______________________________________________________________ _______ _______________ (Please print) Name (Last, First) Sex (M/F) Age on 9/13/15 _________________________________________ ________________________ _____ __________ Street address City State Zip _________________________ ________________________________________ Phone number Email Fees: Preregistration (by 9/8/2015): adults $15; age 18 and under $10 (FLRC members deduct $2) _____ Optional short-­‐sleeve tech T-­‐shirt: add $20 (circle size) Womens S M L XL ; Mens S M L XL _____ Optional additional donation to support the Ithaca Youth Bureau _____ _____ Join FLRC and get discounts on all races, a newsletter, and more! Add $15 for individual membership* *see website for info on family and team FLRC membership Total enclosed: _____ Waiver: I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and have properly trained. I agree to abide by any decision of a race official as to my ability to safely complete the run. I assume all risks associated with running in this event, including, but not limited to, contact with runners, falls, weather conditions including humidity and temperature, traffic and the actions of motorists and adjoining landowners whether unintentional or intentional, and conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I for myself and anyone entitled to act on my behalf, waive and release the Finger Lakes Running Company, Finger Lakes School of Massage, Six Mile Creek Winery, the City of Ithaca, Ithaca Police Department, Local #737 Ithaca Paid Firefighters Assoc., the USA Track & Field Assoc, Ithaca High School, the Finger Lakes Runners Club, the club officers, the race directors, sponsors and volunteers and their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I further grant permission to all of the foregoing to use any photographs, motion pictures, recordings or other record of this event for any legitimate purpose. I also understand that all entry fees are non-­‐refundable. ___________________________________________ ____ /____/ 2015______ Signature (Parent signature required if under 18) Date