Paper Registration

When: June 20th 2015 @9:00 AM
Where: Pleasant Hill Lake Park
3431 St Rt 95 Perrysville Ohio
Cost: $20 Pre-registration / $25 Race Day Registration
*you must register by June 1st to be guaranteed a T-Shirt!
*all other race merchandise will be distributed at a first come first serve basis
The 5th annual BW5K will be held on June 20th 2015 at Pleasant Hill Lake Park
Check in will begin at 8:00 am and the race will start at 9:00 am
This event will take runners through a 5K course through the campground of Pleasant Hill and on the shore line of
Pleasant Hill Lake. This race will be chip timed offered by Ohio Race Day
Medals will be awarded to the top 3 male and female runners in each age category including a trophy/plaque to the top
overall male and overall female runners. All participants will be allowed free access to the park all day for swimming,
fishing, boating & more so bring the family!
Age divisions for the 5k race: awards given three deep in age groups: 14 & Under/ 15-19/ 20-29/ 30-39/ 40-49/ 50-59/ 60
& above, and overall winner male/female.
ONLINE REGISTRATION www.ohioraceday.com
*All proceeds from this event will benefit the Brian Ward Memorial Scholarship.
NAME: ____________________________________ AGE ON RACE DAY: _____ SEX (circle one)
M
F
ADDRESS: __________________________ CITY: ______________ STATE: ____ ZIP_______
(circle one) RUN WALK
Adult Shirt Size (circle one)
Email Address _________________________________ PHONE ____________
Small Medium Large XLarge
WAIVER: I know that running a road race is a potentially hazardous activity. I should not enter unless I am medically able and
properly trained. I assume all risks associated with running this event. Having read this waiver and knowing these facts and in
consideration of your accepting my entry fee, I, for myself, and anyone entitled to act on my behalf, waive and release the
race organization, Ohio Race Day, their representatives and successors, for all claims or liabilities of any kind arising out of
my participation in this event.
________________________________________
Signature (Parent’s Signature If under 18)
_______________________
Date
Make checks payable to Brian Ward Memorial Fund
Mail to Jon VanHouten at 1152 Charwood Road Mansfield Ohio 44907
“IF YOU’RE PLANNING ON RUNNING A 5K THIS YEAR………RUN THE WARD”
For more information email [email protected] or call 419-564-4050
or see the website at http://bw5k.wordpress.com