WHEN: Saturday, May 2, 2015 WHERE: Turner’s Unlimited, Galena TIME: Race starts at 8:00am $20 Pre-Registration ($10 for students – K-12) $30 Race Day Registration (7:00 am) ($15 for students) Participant Name: _______________________________________ (Please print neatly) Email: _____________________________________________ (Please print neatly) Gender: Male ____
Female ____
DOB: __________ Age Group : 9-Under____ 10-14____ 15-19____ 20-29____ 30-39___ 40-49____ 50-59___ 60+___ Tech Shirt Sizes: _____ Youth S _____ Youth M _____ Youth L _____ S _____ M _____ L _____ XL ____ XXL First 100 participants will receive a TECH SHIRT. They will be ordered by April 22nd but you must register before that date to be guaranteed a TECH SHIRT. If you want a TECH SHIRT, please preregister! We cannot guarantee TECH SHIRTS for race day registrations. I will not enter and participate unless I am medically able and properly trained. I assume all risks associated with this event, including but not limited to falls, contact with other participants, effects of weather conditions, traffic and the condition of the road, all such risks being known and acknowledged by me. Having read this waiver and knowing these facts waive and release the Galena PTA, The Galena Lions Club, KCPS system, race officials, volunteers, and all sponsors from all claims and liabilities of any kind arising out of my participation in this event. I grant permission to all of the foregoing to use any photographs, video or any other record of this event for any legitimate purpose. Signature _______________________________________________________________________ Guardian (if under 18) ____________________________________________________________ Please mail registrations & make checks payable to:
Galena Elementary School PTA 114 S. Main Street Galena, MD 2163 5 Questions: Please call Kiki Jones (410) 708-6979 ALL PROCEEDS FROM THE 5K EVENT WILL GO TO THE FUTURE CONSTRUCTION OF A WALKING PATH AT GALENA ELEMENTARY SCHOOL.