REGISTRATION:
REGISTRATION: Participants may pre-register by fax, mail or on Active.com. Participants can also register the day of the event. ENTRY FEES: • $25 Paper Doll Parade • $25 Three Rivers Run 5K DONATIONS: Proceeds from this event will help support The Breast Center at Floyd and fund mammography scholarships for women and men who cannot afford an annual mammogram. Teams are encouraged to develop their own fundraising projects to make this event even more successful. Teams raising the most money will be recognized at The Big Pink Finish. & THREE RIVERS RUN 5K benefitting The Breast Center at Floyd USATF# “GA11052WC Floyd is taking our iconic pink and green Paper Dolls to the streets this October for a fundraising and fun-raising breast health awareness event. ENTRY PACKETS: Pre-registered runners and walkers may pick up race packets and numbers on Friday, Oct. 10, 2014 at The Breast Center at Floyd, 9 a.m. - 6 p.m. T-SHIRTS: DATE: Pre-registered runners and walkers are guaranteed a Paper Doll Parade T-shirt. Saturday, Oct. 11, 2014 5K AWARDS: LOCATION: Floyd Corporate Support Center 420 E. Second Ave. Rome, GA 30161 COURSE: • The Paper Doll Parade is a one-mile, costume-optional walk through downtown Rome. Participants are encouraged to form a team of six or more members and dress in pink and green costumes. Every team registration funds one mammography scholarship. • The Three Rivers Run is a 5K race on Rome’s Kingfisher Trail. Runners are encouraged to dress in pink or green as well to support breast health awareness. EVENT SCHEDULE: 7 – 7:45 a.m. Registration and Packet Pick-up Three Rivers Run 7 - 8:30 a.m. Registration and Packet Pick-up Paper Doll Parade 8:30 a.m. Three Rivers Run Starts 9:00 a.m. Paper Doll Parade Starts 9:15 a.m. Three Rivers Run Awards 9:30 a.m. Big Pink Finish • Male & Female - 1st place for Overall, Masters (40 & over), and Grand Masters (50 & Over) • Male & Female - 1st, 2nd and 3rd in each age group (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, 70-74, 75 & over) PARADE AWARDS: • • • • • • Best Team Name Best Team Costume Best Individual Costume Most Funds Raised Most Team Spirit Best Copy of a Paper Doll Costume All Survivors and Warriors will also be recognized at The Big Pink Finish. For more information or general questions contact: Healthcare Foundation Phone: 706.509.3290 Email: cacarter@floyd.org www.floyd.org Registration Healthcare Foundation Please read and complete carefully. Acknowledgement, General Release and Waiver must be signed. If under 18, applicant must have signature of parent or guardian. Illegible or incomplete entries will not be accepted. No refunds. Race will be held rain or shine. No wheels, radio headsets or animals allowed. Baby joggers, strollers or wheel chairs allowed on Paper Doll Parade only. Paper Doll Parade-Oct. 11, 2014 5K Run Parade (circle one) Fax to 706.509.3293 or Mail entry form and payment to Floyd Healthcare Foundation: 400 Turner McCall Blvd., Ste. 102, Rome, GA 30165 Packets will be available for pick-up Oct 10 from 9 a.m. - 6 p.m. Name: Age(on race day): Address: City: Gender: State: M F ZIP: Email: Shirt size: Youth S Youth M Adult S Adult M Adult L Adult XL Adult XXL Adult XXXL Payment Options: Cash Credit Card - CC#: Exp Date: Signature: Check Payroll Deduction- Floyd Employee #: Signature: If participating in the Paper Doll Parade as part of a team please fill in the following information: Team Name A note about team names: We encourage you to have fun and be creative with your team name. We do ask teams to choose names that are in good taste and without suggestive references. We are happy to provide additional guidance or answer any questions you may have. Are you the team captain? Yes No Are you particpating in honor or in memory of a breast cancer warrior or survivor? Yes No If yes, name of person being honored or remembered: If you wish to make an additional contribution to The Breast Center at Floyd, please add your donation to your registration fee and indicate on check memo. Acknowledgement, General Release and Waiver (‘Waiver”): I hereby acknowledge that participating in this event is a potentially hazardous activity and that I should not walk or run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the walk or race. I 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 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 in consideration of your accepting my entry, I hereby waive and release Floyd Healthcare Foundation, Floyd Medical Center and all 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 any photographs, motion pictures, recordings, or any other recording made of me during or in connection with the race. Signature (Parent/Guardian if under 18) Date:
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