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The Fountain 5K Run/Walk
Benefiting the Volunteer Services Council of Terrell State Hospital
Saturday, April 18, 2015
Ben Gill Park Terrell, Texas
We invite you to experience the charm and heritage of our little city as you pass historic
homes built at the turn of the century on this scenic neighborhood route. This course is
certified and timing services will be provided by All Sports Timing.
While you’re here, enjoy the festivities, food and fun of the 34th Annual
Terrell Heritage Jubilee. For more information, please visit www.TerrellTexas.com
All proceeds benefit the Volunteer Services Council of Terrell State Hospital.
Register by mail:
To register visit:
http://Bswarms.com/swarm289
Race Day Schedule - Rain or Shine
7:00 am
Race Day Registration & Packet Pick-Up
8:45 am
AM Warm Up
9:00 am
5K Run & Walk
10:30 am
Course Closes
Volunteer Services Council
Terrell State Hospital
P.O. Box 70
Terrell, Texas 75160
Registration Fee: Adult-$35, Student-$10
Groups of 10 or more, $25 ea
(includes Race Day T-shirt)
Late Registration after April 3, 2015: $40
(Preferred T-shirt sizes not guaranteed w/late registration)
Medals will be presented to top runners in each age group.
To be eligible for an award, you must wear a timing tag.
1st Overall Male & Female
Top 3 Male & Female finishers in the following age groups:
8 & under, 9-14, 15-19, 20-29, 30-39, 40-49, 50-59, 60-69,
70 & over
Please make checks payable to “TSH Volunteer Services Council”
ALL PARTICIPANTS MUST COMPLETE FORM AND SIGN TO BE VALID
_________________________________________________________________________
FIRST
MI
LAST
DATE OF BIRTH
_________________________________________________________________________
ADDRESS
CITY
ZIP
_________________________________________________________________________
PHONE
SEX: (CIRCLE ONE) F
EMAIL
M
T SHIRT SIZE: (CIRCLE ONE) ADULT S
CHILD
XS
M
S
L
M
XL
L
XXL (ADD $2 FOR XXL)
Entry invalid if not signed. In consideration of the acceptance of registration entry, I the undersigned assume full and complete responsibility for
any injury or accident, which may occur during my participation in the event, or while on the premises. I hereby release and hold harmless the
Fountain 5K, Terrell State Hospital, The City of Terrell, Terrell Chamber of Commerce/CVB, Sponsors, Promoters and all other entities associated
with the event or their agents or employees or otherwise. I will not enter and participate unless medically able and properly trained. I understand
that while police protection will be provided, there may be traffic on the course route. I assume the risk associated with this event, including but
not limited to falls, contact with other participants, effects of weather, and the conditions of the road. Fees are non refundable. I have read the
foregoing and certify my agreement by this signature and my parent’s or guardian’s if under age 18.
Signature: ______________________________________________ Date: ________________________