The 26th Annual
James B. Haggin Memorial Hospital 5K Race
Run / Walk / Obstacle Course & Fitness Challenge
Saturday, May 16, 2015
The James B. Haggin Memorial Hospital Campus
Participants Information
Date:
Saturday, May 16, 2015
Start Times:
Walk - 12:30 PM
5K Race - 1:00 PM
Obstacle Course - 1:00 PM
Race Location:
The James B. Haggin
Memorial Hospital Campus
464 Linden Avenue
Harrodsburg, KY 40330
5K Race / Walk / Obstacle Course
Registration: Individual - $ 25.00
Family - $ 55.00
Teams - $ 20.00 per member
Pre-registration is encouraged.
Late registration will be accepted on race day.
Information Contacts:
Awards: 1st place male & female 5K race winners
1st place male & female obstacle course winners
Cheryl Young 859-733-4833
All participants will receive a T-shirt and ribbon
Jay Lorah, MD 859-733-5864
Race Director:
Rick Serres
Race Courses: 5K course or 1 mile obstacle course
Water and first aid will be available on both courses.
Enter me in The James B. Haggin Memorial Hosptial 5K Race/Walk/Obstacle Course - Saturday, May 16, 2015
Start Times: Walk - 12:30 PM & 5K Race / Obstacle Course - 1:00 PM
(Please Print)
Name ___________________________________________
Address _________________________________________
City _______________________ State ____ Zip _______
Phone _________________________ Age ____ Sex ____
Circle one:
Walk
5K Race
Obstacle Course
Shirt size:
Youth
Medium
Adult
S
M
L
XL
Make checks payable to:
ATTN: 5K Race/Walk/Obstacle Course
The James B. Haggin Memorial Hospital
464 Linden Avenue
Harrodsburg, KY 40330
Amount enclosed $ _____________
WAIVER OF LIABILITY: In consideration of the acceptance of my entry, I
for myself, my heirs, executors, administrators and assignees, do hereby
release and discharge any and all sponsors and associates of the James
B. Haggin Memorial Hospital 5K Race/Walk/Obstacle Course of all claims
of damages, demands or actions whatsoever in any manner arising from
or growing out of my participation in this event. I attest and verify that I
have full knowledge of the inherent risks involved in this event and that I
am physically fit and sufficiently trained to participate. Further, I hereby
grant full permission to any and all of the foregoing to use my likeness for
any publicity and/or promotional purposes without obligation or liability to
me.
Signature __________________________________________
(Parent or guardian must sign if participant is under 18)