Thank you to our sponsors! P O R F O Jill Morton Kidney Transplant Recipient U.S. Transplant Games Gold Medal Winner Tennis 3-Times Gold Medal Winner G R A P H I C S M A I L E R S & P R O M O S SUNDAY, OCTOBER 26, 2014 7:30 AM - 10:00 AM CHARNOW PARK 300 Connecticut Street Hollywood, FL 33019 For more information, to view race course and to register online today visit www.active.com/hollywood-fl/running/run-4-life-2014 RACE STARTS AT 7:30 AM REGISTRATION FORM RELEASE FORM (mandatory) COURSE INFORMATION The 5K Run/Walk event is 3.1 miles and runs around Hollywood Beach strip starting and ending at Charnow Park. For more information and to view the race course, please visit: www.active.com/hollywood-fl/running/run-4-life-2014 If you can’t attend the 5K Race, but would like to help us save lives, visit the link below to make a donation today. https://advancement.miami.edu/netcommunity/ sslpage.aspx?pid=1287 Register online at www.splitsecondtiming.com/run-4-life-5k or complete the attached registration form and mail with payment to: RUN 4-LIFE, Split Second Timing, Inc. 10112 NW 53 Street, Sunrise, FL 33351. Checks should be made payable to the University of Miami Life Alliance Organ Recovery Agency. P Your packet will include your number and race day information. Participants who pre-register online or by mail can pick up their packets the day of the event between 5:30am - 6:45am. Also Sports Authority located at 4100 Oakwood Blvd., Hollywood, FL 33020 will have packets available for pick up on the following days: Friday, October 24th from 12:00pm - 2:00pm and 5:00pm - 8:00pm and Saturday, October 25th from 9:00am - 5:00pm. TIMING This event is using the latest technology in event timing, the ChronoTrack Timing System. Results will be available during the race “real time” through Split Second Timing. AGE GROUPS Awards will be given to the top three male and top three female runners in each of the following age groups: 10 and under, 11-12, 13-15, 16-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70-74, 75 and over. Special awards will also be given to the top three overall male and female runners. For more information, contact Cynthia Smith at 305-243-9630 or via email at [email protected] RACE DAY SCHEDULE F O O R REGISTRATION INFORMATION PACKET PICK UP In consideration of accepting this entry, I, the undersigned, intending to be legally bound hereby, for myself, my heirs, executors and administrator, waive and release any and all rights and claims for losses and damages I may have against the University of Miami, Split Second Timing, the City of Hollywood, Charnow Park, race directors, their officers, directors, members and volunteers, physicians or health care professional present, any and all sponsors including other parties and their representative successors, and assigns for any and all injuries suffered by me in said event. By proceeding with this event registration, you agree that the terms of the Registration Agreement shall apply equally to you and to any third parties for whom you are acting as agent. Compliance with Children’s Online Privacy Act (COPPA): You represent and warrant that, in compliance with COPPA, you are over thirteen (13) years of age and that if you are registering a child, and do hereby consent to the collection of such child’s personal information for the purpose of registration. I attest that I am physically fit and have sufficiently trained for the competition of this athletic event and competition which I am voluntarily entering at my own risk. My physical condition has been verified by a licensed medical director. Further, I hereby grant full permission to any and all foregoing to use photographs, videotapes, motion pictures, recordings or any other record of this event for any purpose whatsoever. USE OF HEADPHONES, ROLLERSKATES/INLINE SKATES AND BABY JOGGERS ARE NOT PERMITTED ON THE COURSE. NO ONE MAY ENTER THIS EVENT WITHOUT SIGNING THIS OFFICIAL WAIVER. 5:30am - 6:45am /Registration 7:30am / 5K Run/Walk Begins 8:00am /Kids Fun Run Begins 8:45am /Awards Ceremony 7:30am -10:00am /Health Fair COMPLETE ENTIRE FORM AND SIGN WAIVER/RELEASE FORM (Please print clearly) Race Category (circle one), one form per participant 5K Run/Walk Last Name: First Name: Age on Race Day: Date of Birth: Print Name: Date: HEAT WARNING: Temperatures/humidity can be high in South Florida. Participants should drink plenty of non-alcoholic fluids or sports drinks for 48 hours prior to, during, and upon finishing the race. Beware of heat injury symptoms (dizziness, no sweating, nausea, cramps, redness, incoherent speech and thoughts). Seek immediate assistance if symptoms occur. Wear loose, light colored clothing, a hat and sunscreen. Male Address: Female Apt #/Suite: City: State: Zip: Email: Phone: Shirt Size (check one) S If under 18, signatures of legal guardian & participant are required. Signature: 1K Fun Run M L XL ENTRY FEES: 5K Pre-Registration $25.00 5K Race Day Registration $35.00 Mail completed form with payment to: RUN 4-LIFE, Split Second Timing, Inc.10112 NW 53 Street, Sunrise, FL 33351. Checks should be made payable to University of Miami Life Alliance Organ Recovery Agency No entry accepted without registration fee. No refunds. Race will proceed rain or shine. All proceeds will benefit organ, eye and tissue donation education efforts.