Levels of Sponsorship Please circle level of sponsorship “R”eading Sponsor $500.00 + ***Receives 6 free race registrations, publicity at the event, advertisement online, and local media press releases. W”r”iting Sponsor $250.00 + ***Receives 4 free race registrations, publicity at the event, advertisement online, and local media press releases. A”r”ithmetic Sponsor $100.00 + ***Receives 2 free race registrations, publicity at the event, advertisement online, and local media press releases. Sponsor Name:____________________________ Company Name:___________________________ Address:__________________________________ _________________________________________ Phone:___________________________________ E-mail:___________________________________ Please make checks payable to: Sue Daniels Memorial Run/Walk for Backpack Buddies Mailed to: 1100 Southerland Road Clayton, NC 27527 Hand Deliver to: JD’S Country Store 4549 Wilson’s Mills Rd. Smithfield, NC 27577 Directions: From Raleigh/Durham: Take I-40 East to exit 306 toward Clayton. Travel on US Hwy 70 Business. Merge onto US 70 East via exit 309 toward Smithfield/Goldsboro. Sue Daniels Memorial Run/Walk For Backpack Buddies From Clayton: Take US 70E exit 309 toward Smithfield/Goldsboro. Turn left onto Swift Creek Road. Proceed to stop sign at intersection of Swift Creek Road and Wilson’s Mills Road. Turn right onto Wilson’s Mills Road. Turn left onto Fire Department Road. From Smithfield: Take US 70 W to the stop light at Wilson’s Mills Road. Turn right onto Wilson’s Mills Road. Turn right onto Fire Department Road. Parking: Parking will be available at JD’S Country Store, Wilson’s Mills Elementary, and the NC Truck and Diesel Shop next to Wilson’s Mills Town Hall. Ways to Participate: *Attend the Pre-Race Spaghetti Dinner on Friday, October 10th from 4:30-7:30 at Wilson’s Mills Elementary School ($7.00/plate). *Sign up to participate in the 5K/10K run/walk. *Organize teams of runners/walkers to participate in the event & set a fundraising goal. *Encourage team members to set personal fundraising goals & obtain sponsors for their participation in the event. When: Saturday, October 11, 2014 5K/10K Race starts at 9:00 am Where: Wilson’s Mills Town Hall 101 Railroad Street Smithfield, NC 27577 The course begins and ends at the Wilson’s Mills Town Hall. At 8:30 am events will be held for children. Event Proceeds: Sue Daniels Memorial Run/Walk For Backpack Buddies When: Saturday, October 11, 2014 Where: Wilson’s Mills Town Hall 101 Railroad Street Smithfield, NC 27577 100 % of the proceeds for the Sue Daniels Memorial Run/Walk will help support the Backpack Buddies Program. Currently, the program supports approximately 200 students by sending food home with the children in the program every Friday for the weekend. The items packed for the students include nonperishable breakfast, lunch, and snack foods. Volunteers, local churches, and individual donors have supported this program over the past many years. Map: Sign-up Form Sign up for: 100 Yd. Dash Before After 9/1/2014 9/1/2014 Preschool Kids 10.00 15.00 200 Yd. Dash K-2nd Grade 400 Yd. Dash rd th 3 -6 Grade 10.00 15.00 10.00 15.00 25.00 30.00 5K Walkers 25.00 30.00 10K Runners 25.00 30.00 5K Runners Name Address Phone Email Method of Payment Check Shirt Size Cash Race Day Schedule All runners will receive a shirt and medal Check-In: 8:00-9:00 am Participant Waiver for Race Registration I know that running [volunteering for] a road race is potentially hazardous activity, which Events for Kids: 8:30 am 5K/10K Race: could cause injury or death. I will not enter and participate unless I am medically able and properly trained, and by my signature, I certify that I am medically able to perform 9:00 am this event, and am in good health, and I am properly trained. I agree to abide by any decision of a race official relative to any aspect of my participation in this event, including the right of any official to deny or suspend my participation for any reason whatsoever. I attest that I have read the rules of the race and agree to abide by them. I Pumpkin Festival: 10:00 am This event will take place rain or shine. You can follow us on Facebook at: Sue Daniels Memorial Run for Backpack Buddies assume all risks associated with running in this event, including but not limited to: falls, contact with other participants, the effects of the weather, including high heat and/or humidity, traffic and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and inconsideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the Sue Daniels Memorial Run/Walk for Backpack Buddies, the town of Wilson’s Mills, Wilson’s Mills Elementary, Wilson’s Mills Elementary PTA, Johnston County Schools, and all event sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event, even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission to all of the foregoing to use my photographs, motion pictures, recordings or any other record of this event for any legitimate purpose. _____________________________________________________________________________ Participant Signature (parent/guardian if under 18)