Nason Hospital 5 K & Wellness Walk ( An Event of the 2015 Cove Challenge Series) Proceeds will benefit The Garver Memorial YMCA & Through, Inc. Dogs are welcome with walkers and runners -‐ but must be on lead! TROPHIE Date: April 11, 2015 Time: 9:00 AM Trophies will be given to the first three overall male and female finishers in the 5 K run. Pre Pre--register -register by: 4/4/15 Entry fees: x x x $18.00 (5 K Run) pre-‐registered by 4/4/15, $20 post registered 4/5/15³4/11/15 $35.00 family registration, register by 4/5/15 (5 K Run) $10.00 Walkers All races start and end at Through Inc. 2879 Everett Road East Freedom, Pa. 16637 For more information or to register call: 814 224-‐5101 Make fee payable to Garver YMCA & mail to: Garver Memorial YMCA 820 Grove Street Roaring Spring, PA. 16673 Phone:(814)224-‐5101 Fax: (814)224-‐5103 Entry fees are non-‐refundable. Thank you! Medals will also be awarded to the first, second, and third place finishers in each age group for the 5 K run. Come out early and participate in health screenings including a lab screening for $25 that includes: Chem 16, CBC, and lipid profile. Please fast for 12 hours prior to testing. Name ____________________________ Address ____________________________ Email:_______________________ Phone:______________________ Phone:______________________ Participant in: 5K Run, 1M Walk, (circle) Kids Fun Run T-shirt Size: S M L Youth Size: S M L Sex : M F XL Age on race day In consideration of your accepting my entry, I hereby, for my heirs, my assigns, and myself release Nason Hospital, Garver Memorial YMCA, and the sponsors of The Nason Hospital 5 K & Wellness Walk Committee from any and all liabilities arising from illness, injuries, or damages I may incur as a result of my participation in The Nason Hospital 5 K & Wellness Walk, to be held April 11, 2015. I agree that my name subsequently may be used by the sponsors for publicity purposes without obligation to me. I certify that I am fit to participate in this event. Signature:______________________ Date:_______ Signature of Parent or Guardian if under age 18: __________________________________________
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