Charlotte County Community Services Presents the... 3rd Annual Tippecanoe Trail & Mud Run Saturday November 22, 2014 Tippecanoe Environmental Park 2400 El Jobean Road, Port Charlotte, FL Check-In begins at 7:30 a.m. 10K Trail Run 8:30 a.m. First Wave Start (may be modified) 5K Trail Run 9:30 a.m. First Wave Start (may be modified) 1 Mile Adult Walk and Kids Fun Run (12 & Under) Starts at completion of 5K & 10K Runs BEWARE THE OBSTACLES! Teeter Walk Muddy Tires FUN FOR THE ENTIRE FAMILY Visit the Charlotte Harbor National Estuary Program’s Nature Festival after the run! Spider Web Sand Run The Hurdler The Climb Water Cannon The Maze Muddy Trails Hay Bale Wall Cargo Dome Culvert Crawl GREAT AWARDS, PRIZES AND MORE! Medal awards in 10 Age Groups for 5K & 10K (min. age 10) Team awards for top 3 overall in 5K & 10K Corporate Challenge Discounts Participants registered by November 12 guaranteed an official Race Dry Fit T-Shirt Post race entertainment & food Chip timing & More! REGISTER BY OCTOBER 15, 2014 FOR BEST VALUE! REGISTER AT ACTIVE.COM The 3rd annual Tippecanoe 5K & 10K Trail Run is a community event promoting environmental awareness and helps Charlotte County protect some of our most valuable natural resources parks like Tippecanoe Environmental Park. Visit www.CharlotteCountyFL.gov or call 941.613.3220 for additional event information. An event of Charlotte County Government THANK YOU TO OUR SPONSORS! Some Tippecanoe Features Over 350 acres of natural Florida wildlands Nesting osprey and bald eagles Historical middens dating back 2,500 years 100+ varieties of birds Home to a family of Florida scrub jays Contains over 7 miles of nature trails Registration Fees: Price Prior to 5:00 p.m. October 15, 2014 Kids Fun/Adult Walk-Run (No online registration for Fun Run) $10.00 5K/10K Trail Run $40.00 3 Person Team (at least one female) $115.00 The Parrot Select One Kid / Adult 5K / 10K 5K / 10K October 16 - November 21, 2014 Kids Fun/Adult Walk-Run $15.00 5K/10K Trail Run $45.00 3 Person Team (at least one female) $130.00 Kid / Adult 5K / 10K 5K / 10K CORPORATE DISCOUNT (5 or more participants from your business) Deduct $5.00/person from 5K or 10K run fees. Deadlines still apply. SUBMIT ALL ENTRIES TOGETHER TO RECEIVE DISCOUNT Day of Race Kids Fun/Adult Walk 5K/10K Trail Run 3 Person Team (at least one female) Solid Waste Division Entertainment Magazine $15.00 $55.00 $160.00 Kid / Adult 5K / 10K 5K / 10K Business Name ________________________________________ Waiver/Release of Liability 1. Last Name Your Other Team Members’ Names First Name Age M/F 2. Last Name First Name Age M/F In consideration for Charlotte County through its Community Services Department providing facilities, instruction, and/or supervision in the program listed above, the Undersigned does hereby release and hold harmless employees or agents of Charlotte County and the Board of County Commissioners from any and all liability, existing now or in the future, suffered or caused by the Undersigned or the Child/Ward of the Undersigned, while said Undersigned or said Child/Ward is engaged in any program connected with the Charlotte County Community Services Department. The Undersigned requests permission to participate in the program with full knowledge that said program could result in damage or injury to the Undersigned or Child/Ward of the Undersigned and assumes all risk of possible damage or injury involved through participation in the above noted program. Your Entry Information First Name Last Name Address City Phone Cell Phone Birth Day (DD/MM/YYYY) Age on Race Day State Zip Male Female I understand that program participants may be photographed/videoed by the Charlotte County Community Services Department and the local media for publicity of the program. Email Shirt Size (Circle One) XS S M L XL XXL XXXL (Add $5) Kids M Kids L Estimated Finish Time 5K / 10K Signature Acknowledging Waiver of Liability (Parent or Guardian must sign if under 18 years of age) Method of Payment Check: Make payable to Charlotte County Board of County Commissioners (B.C.C.) Master Card Visa Credit Card # Card Holder Name (Please Print) Printed Name Date (NO CASH PLEASE) Exp. Date Card Holder Signature One entry form per individual. Entries received after 5:00 p.m. on 11.12.14 will not be guaranteed a race shirt or Goodie bag. Online Registration Powered by Active.com or mail with payment to: Charlotte County Community Services Attention: Tippecanoe Trail Run 2300 El Jobean Road Port Charlotte, FL 33948
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