4th Annual Make A Wish 5k Run/Walk
Saturday, May 16, 2015 ~ 8:00 a.m. ~ Dixon, IL
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Registration Information
Register By Mail or
Register On-line at
https://register.chronotrack.com/r/13248
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Race Day Registration and Packet Pick-Up
Saturday, May 16th – 6:45-7:45 a.m. at race site
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5k Run/Walk Fees
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$20 Early Registration prior to 5/1/2015
$25 Late Registration after 5/1/2015
RRRR Club Members ONLY:
$18 Early Registration prior to 5/1/2015
$25 Late Registration after 5/1/2015
Course and Race Information
The race begins and ends at Washington Elementary School, 703
East Morgan Street, Dixon, IL.
Fast, flat course on Lowell Park Trail with water station.
NEW for 2015! Course is chip timed.
Awards ceremony immediately following race.
Race will be held rain or shine. In case of inclement weather,
thank you for your donation.
Race is featured as a 2015 Rock River Road Runner’s Circuit Race.
Discount for early registration applies to RRRR Club members
only.
Technical race shirts are guaranteed with early registration.
Awards
Awards will be presented to the overall male and female finishers. NEW
for 2015- awards will also be presented to the overall Masters male and
female finishers! Medals will be presented to the top three male and
female finishers in the following age categories: 10 & Under, 11-14, 15-19,
20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70 &
Over
Make Checks Payable to Trevor Belzer
All proceeds benefit Make-A-Wish Foundation!
Race Website:
Contact Information
www.makeawish5k.webs.com
Find Us on Facebook: Dixon Make a Wish 5k
Trevor Belzer, Race Director
Phone: 563-343-2897; Email: [email protected]
Lisa Knebel-Cullen, Make-A-Wish Representative
Email: [email protected]
THANK YOU FOR YOUR SUPPORT OF MAKE A WISH!
(mail with payment to: Trevor Belzer, 378 Kilgore Road, Dixon, Illinois 61021)
First/Last Name: ________________________________________________________________ Gender:
M
F
Phone Number: ________________________________ Email:_____________________________________________
Address: ________________________________________________________________________________________
(Street)
(City)
(State)
Age on 5/16/2015: ___________ Birth Date: ______/________/________
mm
Register for:
day
year
_____ 5K Run/Walk - $20 prior to 5/1/2015; $25 after 5/1/2015
_____ RRRR Club Members Only - $18 prior to 5/1/2015; $25 after 5/1/2015
(Zip)
Sport Performance
Technical Shirt Size:
Adult sizes:
S
M
L
XL
*shirts are technical shirts featuring moisture
management. Shirts are guaranteed with early
registration. Shirts available on race day in
limited quantities. Shirts run SMALL.
Release and Wavier: In consideration of my entry, I, intending to be legally bound, for myself, my heirs, executors, administrators, and
assignees, waive, release, and forever discharge any and all rights and claims which may hereafter accrue to me against Washington Elementary
School, Dixon Public Schools, Make-A-Wish Foundation, the 5k Race Committee, City of Dixon, Dixon Police officials, Dixon Park District and all
other sponsors, officials, and volunteers for any and all accidents and injuries incurred by me at or during this event. I further state that I have
trained adequately and am in suitable condition to compete in this event.
Signature: ___________________________________________________________________________________Date: ____________________
Parent Signature (for participants under 18):____________________________________________________________Date: ____________________