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Pennsylvania DUI Association
2413 North Front Street
Harrisburg, PA 17110
(717) 238-4354
12th Annual
DUI Victims Memorial
10K Run/1 Mile Walk
Saturday, May 16, 2015
The Pennsylvania DUI Association is a
non-profit organization established in
1979 to support highway safety initiatives
being undertaken throughout Pennsylvania. The Association is working to eliminate impaired driving and the destruction
it causes, by promoting safety on Pennsylvania highways.
Pennsylvania DUI Association
2413 North Front Street
Harrisburg, PA 17110
(717) 238-4354
The 12th Annual DUI Victims Memorial 10K
Run and 1 Mile Walk is dedicated to
remembering DUI Victims. The proceeds
raised from this event will be used to
maintain the Pennsylvania DUI Victims’
Memorial Garden, and to promote the
elimination of impaired driving.
Your support will help send the message that
Pennsylvanians are willing to
Take the Steps to Remember DUI Victims.
Saturday, May 16, 2015
LOCATION
Pennsylvania DUI Association
2413 North Front Street
Harrisburg, Pennsylvania
(on the Harrisburg Riverfront Park)
SCHEDULE
AWARDS
Last year Pennsylvanians lost their lives to
drunk driving, and even more were injured
in alcohol-related crashes. These tragedies
devastate the lives of tens of thousands of
friends, relatives, neighbors and coworkers.
$20.00 Registration Fee
$25.00 After May 1, 2015
Children Under 3 Free
10 K Run
10 K Walk

1 Mile Children’s Run
1 Mile Walk

Name: ____________________________________________
8:00-8:30AM Registration at 2413 N. Front St.
8:45AM
Runners to be at starting point
along Riverfront Park
9:00AM
10K race starts promptly
9:05AM
1 Mile Walk & Children’s Run
10:45AM
Awards ceremony
On October 2, 2003, the Pennsylvania DUI
Association dedicated the first statewide
DUI Victims’ Memorial Garden.
The Garden is a place where Pennsylvanians
can remember and honor their loved ones by
arranging to have an engraved brick placed
in the Garden. Since its dedication, over
1,900 DUI Victims’ names have been added
to the Memorial Garden.
REGISTRATION FORM
10K Race — Plaques for top three male & female finishers overall. Medallions awarded in
age groups 19 & under, 20-29, 30-39, 40-49,
and 50+.
1M Run/Walk — For top three boys and girls
(age 18 and under)
CONTACT INFORMATION FOR
QUESTIONS OR TO RETURN
REGISTRATION VIA FAX OR E-MAIL
PHONE: (717) 238-4354
FAX:
(717) 238-6211
Rick Miller ([email protected])
Russ Young ([email protected])
Registration form also available online at
the Association website: www.padui.org
and www.active.com
Address: __________________________________________
City, State and Zip Code: _____________________________
Phone: (
)______________________________________
Email: _____________________________________________
Age as of 5/16/2015: __________
Sex: M F
Date of Birth: _____/_____/_____
T-Shirt Size: __________________________________
Adult: S M L XL XXL XXXL
Youth: S M L
By signing this registration form, I waive all claims for myself, my heirs, and
assigns the sponsor, coordinating groups, and any individual associated with the
event and will hold them harmless for any and all injuries or illness which may
result from my participation. I further state that I am in proper physical condition
to participate in these races. I give my permission to the media to use my name
and/or photo in any newspaper broadcast, telecast or any other account of this
event, without limitation and without obligation of anyone to compensate me
thereof.
Signature: ____________________________________
Parent or guardian if under 18:
CHECK/MONEY ORDER PAYABLE
TO: PA DUI Association
2413 North Front Street
Harrisburg, PA 17110