Help support victims of domestic violence Sunday, May 24th, 2015 at 10:00am Proceeds to benefit Ruth Ann’s House Transitional House for Homeless Women & their Children Port Clinton Recreation Department DATE & TIME MAY 24, 2015 • Registration begins @ 9:00 am Run/Walk begins @ 10:00 am Awards: following @ Walleye Festival Event Tent LOCATION Race begins and ends at Jefferson St. Pier AWARDS • Overall 5k winners: Male & Female • First place male & female for 5k run - each age group • First, Second, and Third place in each division (ribbons) • First place male & female for 5k walk AGE DIVISIONS • 15 & under • 30-34 • 50-54 • 35-39 • 16-19 • 55-59 • 40-44 • 20-24 • 60-64 • 45-49 • 25-29 • 65 & older NEW COURSE Safe, secure course on flat residential streets ENTRY FEES (no refunds) $20.00 pre-registration paid by May 22nd $25.00 day of registration Register by mail with check payable to: Ruth Ann’s House P.O. Box 93 • Port Clinton, OH 43452 Linda Hartlaub 419-734-9718 FEATURES • T-shirts to all pre-registered and while supplies last on race day • Refreshments following the event 1812 Food & Spirits and Rosie’s Bar & Grill WALLEYE WALK & 5K RUN ENTRY FORM parkpress D I R E C T FULL SPECTRUM PRINTING www.parkpressdirect.com By signature I attest that I am physically fit and sufficiently trained to participate in this event. I have full knowledge of the risks involved. I NAME: _____________________________________________________________________ further acknowledge that the race may contain uneven surfaces, including but not limited to pot holes, curbs, sewer covers, and entry routes that mat AGE: _______ SEX: ____ DATE OF BIRTH: ____________ PHONE: ___________________________ create risk: I further acknowledge that the race course is on public roads and that vehicular traffic may be encountered and I accept these risks. ADDRESS: __________________________________________________________________ Therefore, in consideration of the acceptance of this entry, I myself, my executors and administrators waive and release any and all claims for the CITY/STATE/ZIP: ___________________________________________ SHIRT SIZE: _____ damages that I may have against the Walleye Festival, Port Clinton Recreation Department, Ruth Ann’s House, City of Port Clinton, sponsors, contributors and any individuals associated with this event and will EMAIL: ____________________________________________________________________ hold them harmless for any and all injuries I may suffer in conjunction Entry Fees: Event: 5K RUN___ 5K WALK___ $20.00 Pre-registration • $25.00 Race day registration Checks payable to: Ruth Ann’s House P.O. Box93, Port Clinton, OH 43452 with this event. ________________________________________________________________ SIGNATURE (Parent or Guardian if under 18 years of age)