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: