1. education
2. school

2014 Boys & Girls Club of Chambersburg/Shippensburg 5k
Run/Walk
Sunday, October 19, 2014
Registration begins at 10:00 a.m. at the Chambersburg South Gate Shopping Center
Race starts at 11:30 a.m.
Course: A fast course using the adjacent rail trail and surrounding streets/neighborhoods
Awards:
• Top Overall Male/Female
• Top 2 Male/Female in age groups: 19 & under, 20-29, 30-39, 40-49, 50-59, 60-69
• Top Masters Overall Male/Female 40+
• Top 2 Overall 70+
T-shirts: All pre-registrants are guaranteed a short-sleeve t-shirt
Cost: $20 postmarked by 10-01-14; $25 postmarked after 10-01-14
Event will be held rain or shine.
*Proceeds to benefit the Boys & Girls Club of Chambersburg and Shippensburg*
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Registration Form
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Check Appropriate Event
Make checks payable to: Boys & Girls Club of Chambersburg and Shippensburg
5k before 10/01/14...$20.00
First
Male
Female
5k after 10/01/14......$25.00
Age on
Last
Donation...........$________
Street
T-Shirt Y
City
State
Zip
Phone
-
-
S
M
L
XL XXL
Size
Our preferred method of contact is email. Please provide if possible
Email
Waiver Must Be Read and Signed - I know that running a race is a potentially hazardous activity and that I should not enter the event unless I am medically able and properly trained. I agree to abide by any decision of
an event official relative to my ability to safely complete the event. 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 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 in consideration of your accepting my entry, I, for myself and anyone entitled
to act on my behalf, waive and release the organizers, Timber Hill Technology Solutions, LLC and all other sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event or
carelessness on the part of the persons named in this waiver. Further, I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for legitimate purposes. All fees are
nonrefundable.
Signature (parent or guardian must sign if under 18 years old)
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Return race forms to: Boys & Girls Club of Chambersburg and Shippensburg, ATTN: Cressa Coldsmith, 440 West Washington St.,
Chambersburg, PA 17201 or fax to 717.264.8761
Questions? Contact Race Director: Cressa Coldsmith, 717.261.5761, [email protected]