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COVINA ROTARY ED KISSELL MEMORIAL
FUN RUN XIX
Saturday, March 21, 2015
South Hills High School, West Covina
645 S. Barranca, West Covina, 91791
Timeline
8:00 am Registration Opens
8:00 am Pancake Breakfast Opens
9:00 am 5k Run/Walk
10:00am 1 mile Run/Walk
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1 mile Fun Run
5k Run/Walk
FUN for the whole family!
Pancake Breakfast for Everyone-FREE for runners!
 GREAT for school teams and running clubs!
FREE T-Shirt for all runners
FREE goodies for runners!
Medals given to all youth1 mile runners!
1st, 2nd, 3rd place medals for 5k runners in each
age category, by gender and an overall
1st, 2nd and 3rd place Trophy.
1 mile runners group picture to be published in
the San Gabriel Valley Tribune.
* Registration must be postmarked by 3/5/2015. If postmarked after above date, all late
registrations will pay the Late Registration fee and may not be guaranteed a T-Shirt.
Early Entry Fee
Late Registration
(postmark after
3/5/2015)*
Adult
$30
$35
Adult Group Rates**
(10 or more)
$25
$30
Children
(18 yrs. and under)
$15
$18
Children Group Rates**
(10 or more)
$10
$12
All funds raised support Teacher Mini-Grants for Covina - Valley and Charter Oak Unified
School Districts along with other community service projects.
For more information, email [email protected] and put ROTARY FUN RUN in
the subject line. Professional timing done by Pacific Coast Race Timing.
You can also register on-line at: www.pacificcoastracetimingonline.com/reglivecb.aspx?eventyear_id=58
Mail entry with check payable to: Covina Rotary Fun Run, P.O. Box 334, Covina, CA 91723
Name ___________________________________________________________________
Last
First
M.I.
Address__________________________________________________________________
City______________________ State____________ Zip________ Gender: M_____ F_____
Amount Enclosed:
$ _____________
Rain or Shine Event
(no refunds)
Hm Phone _____________________Wk Phone _____________________Age __________
Email: ____________________________________________________________________
Check One Race Category Only: _____5K Run/Walk
Circle T-shirt size:
Youth:
S
M
_____1 Mile Fun Run/Walk
L
Adult:
S M
20-29
30-39
40-49
L
XL XXL
Teacher:
__________________
Circle Appropriate Age Division:
9 & Under
10-14
15-19
50-59
60-69
School or Class
Affiliation:
__________________
70 & over
I hereby assume the risk of injury, and release, discharge and indemnify the Covina Rotary Club, City of West Covina,
Covina-Valley Unified School District, its volunteers and others associated with this event, from any and all claims for
injury or damages arising from participation in the “Fun Run.” I know of no medical reason that would prevent my safe
participation in this run. I hereby permit the Rotary Club free use of my name and picture in broadcasts, telecasts,
periodicals, newspapers, and brochures in reports and promotion of this event.
_______________________________________________________
Signature of Runner (signature of Parent/Guardian if under 18 years)
_________________
Date
The Covina-Valley and the Charter Oak Unified School Districts do not sponsor the organization or activity
represented in this document.