Erie County’s Health & Wellness Program’s 4th Annual New: Tech Shirts! JAILBREAK 5K RUN/WALK Saturday, August 15th, 2015 Pictured Above: Is our JailBreak Mascot that ran the 2014 race! Race Information: This is a 5K (3.1 miles) loop course, starting and ending near the Erie County Jail, winding behind the Erie County Services Center into the Oakland Cemetery and returning to the Erie County Jail. All profits from the race support Make-A-Wish. Kids Fun Run will start near the Erie County Jail and end near the Service Center. First 90 adults and 30 children registered will receive a t-shirt! First come first serve on sizes! RACE DAY REGISTRATION: 8:00 AM for Runners and Walkers RACE START TIME: 9:00 AM RACE APPLICATION FEE: $15.00 Pre-reg. by Aug. 10 /$20 race day Prizes: Kid’s Fun Run 10 & Under: RACE DAY REGISTRATION: 8:00 AM Race Start Time: 8:40 AM Race Application Fee: $10.00 Pre-reg. by Aug 10/$15 race day All participants will receive a participation award! Awards to top overall male & female runners Awards to top overall male & female walkers Age group 1st place awards (14& under, 15-19, 20-29, 30-39, 40-49, 50-59, 60-69, & 70+) Special Law Enforcement Division (check if applies) ____ Yes, I am a law enforcement (added award division) HS/MS Cross Country Teams– Register 5 or more team members together (with Coach Name listed) $10/each Door prizes (must be present to win) ENTRY FORM: Last Name:_______________________________ First Name: _______________________________ Street Address: _______________________________________________________________________ City: ____________________________ State:____________________ Zip:_____________________ Email:_______________________________ Race Day Age:_______ Phone: _____________________ EVENT (check one): ___5K Walk ___5K Run ___Kids Run MALE FEMALE MS/HS Cross Country Team: ________________________________ Coach:_____________________ T-shirt Size for Pre-registered: ____S _____M ____L ____XL ____ XXL Kids Sizes: ___YS ___YM ___YL In Signing this registration for myself or for the entrant (when under age 18) I understand the intent of this release and agree for myself, my heirs, and assignees, to absolve all of the sponsors, organizers, and associated entities, be they individuals or organizations, singly and collectively, of all blame for any injury, misadventure, harm, loss, or inconvenience suffered as a result of participating in the JailBreak 5k run/walk & fun run, and will allow publication of any photos or quotes acquired during the run. _______________________________________ ______________________________________________ Runner/Walker Signature (required) Signature of Parent/Guardian if Under 18 (required) Return Form AND Payment To: Erie County Human Resources Department ATTN: Amy Palsa 2900 Columbus Avenue, Sandusky, OH 44870 Make Checks Payable to: Make-A-Wish (No Refunds) Contact for Info: 419-627-7678 RACE TIMING BY FIRELANDS AREA RUNNERS CLUB