5K Run/Walk Saturday, April 25, 2015
Indian Hill Student Registration $10 including t-shirt! Must register with this form by Friday, April 3 5K Run/Walk Saturday, April 25, 2015 7 a.m. - Registration and Packet Pick-up at Indian Hill High School 8:30 a.m. - 5K Start at Indian Hill High School 9:45 a.m. - New “Run the Bases” for ages 7 & under Presented by the Indian Hill School District Wellness Committee and the Indian Hill Public Schools Foundation Includes a T-shirt for those over age 10 if REGISTERED by Friday, APRIL 3 Free registration for students 10 and under, t-shirt is $8 Early Packet Pick-up Friday, April 24 at the High School from 2-6 p.m. The race begins at Indian Hill High School, 6865 Drake Road 45243 Runs through Indian Hill & finishes on the track at Tomahawk Stadium Community, Students, Families, Friends, Alumni, Faculty and Staff Strollers Welcome Finish Line Celebration Complimentary Refreshments Proceeds benefit all the students of the Indian Hill Schools For more information visit www.ihpsf.org Pre-Registration is available at online at www.ihpsf.org by Tuesday, April 21, 2015 or by mailing your entry form and fee postmarked by Friday, April 17, 2015 REGISTRATION FEES ARE: Pre-Registration Prices Event Day - Registration Prices Kids 10 & under - FREE $ 15 Students 11 to 19 - Kids 10 and under - FREE ($8 for kids t-shirt if available) ($8 for kids t-shirt) Students 11 to 19 - $ 15 ($15 for t-shirt if available) IH Students 11-19 $10 by April 3 Adult single $ 20 Group of 2 Adults $ 30 Group of 4 Adults $ 60 Adult single - $ 25 ($15 for t-shirt if available) Entry fee includes a FREE T-shirt if REGISTERED by FRIDAY, APRIL 3 Ribbons for all 10 years and under participants Medal and Prize for First Place Male and Female Runners Medals for 1st, 2nd, 3rd, 4th place runners for ages 11-14 and ages 15-19 Medals for 1st, 2nd, 3rd place runners for each age level 20 & over Running levels- Men and women runners: 10 & under, 11-14, 15-19, 20-29, 30-39, 40-49, 50-59, 60 & over Medals for first 5 walkers Refreshments, Live Music, and Door Prizes, for participants after the race Bring your Family, Friends, Co-workers - Runners, Walkers, Strollers Welcome! Indian Hill Student Conquer the Hill Registration by April 3 $10 ages 11-19, free for ages 10 and under First Name: ________________________________ Last Name: ________________________________ Gender: __M __F Age (race day): ___ Category: __ 5KRun __5KWalk T-Shirt Size: (Circle one) S M L XL XXL child: S M L Daytime Phone ______________ ($8 for those under 10) Email___________________________________ Address_________________________________City______________________State_____ Zip_________ Waiver: In consideration of the acceptance of my entry, I hereby waive on behalf of myself, my heirs, executors, and assigns, any and all claims of any nature arising from or due to my participation in the Conquer the Hill 5K run/walk. I also hereby release Indian Hill Exempted Village School District, Steve Prescott, USATF, all sponsors, workers, officials, and volunteers from any and all claims arising from or due to my participation in this event. I agree to follow all the rules of participation and acknowledge that the race committee may refuse or return my entry at its discretion. I understand the risks for such a run or walk, and have trained and prepared adequately in preparation for this event. I HAVE NOTED ANY MEDICAL CONDITION ON THE REVERSE SIDE OF THIS FORM. I permit the use of my name and picture participation in this event for publicity, for no additional consideration. I also understand that entry fees are non-refundable. Signature________________________________________________Date_______________ Parents Signature (if under 18)________________________________Date_______________ Emergency Contact_________________________________ Phone Number_______________________ Mail form & check payable to IHPSF by Friday, April 3, 2015 to: Conquer the Hill, c/o Steve Prescott, P.O. Box 454, Mason, OH 45040 Groups must mail SEPARATE forms TOGETHER in ONE envelope with payment if you want the group pre-registration rate
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