-In Recognition of Armed Forces DayProceeds benefit Allegany Arc Staff and Consumer Wellness Saturday, May 16, 2015 Start times: 9:00 am Kids Fun Run 9:30 am Runners/Walkers Timing provided by RaceWire Racing Registration (day of event): 8:00 am-9:00 am at Allegany Arc, 240 O’Connor Street, Wellsville, NY Entry Fee: Early Bird price until April 24th - $20.00; after April 24th - $25.00 Divisions: Kid’s Fun Run Men’s/ Women’s/ “I am able” (special needs) Walk/Run: 14-under, 15-29, 30-49 and 50-up Awards presented at end of race to the top three finishers in each division, as well as overall male and female. Shirts to all registered participants who are registered by April 24, 2015. Race around Allegany Arc Kids Fun Run-for kids 10 and under. All participants will receive a participation ribbon. $5.00 entry fee (No shirt). Please note children cannot be left unattended. Course Route will be marked with signs. Course Route is available on our Facebook Page and at www.AlleganyArc.org. You can also log onto www.AlleganyArc.org to register for the event. PayPal is accepted. Questions? Please call Diana Gowdy or Heather Perkins at 585-593-5700. Mail Entry Form To: Allegany Arc, attn: Diana Gowdy or Heather Perkins, 50 Farnum Street, Wellsville, NY 14895 Make Checks Payable To: Allegany Arc ************************************************************************************************** Registration and Liability Form Name: _______________________________________ Male/Female DOB: _________________ Shirt Size (circle one): YL, S,M,L,XL,XXL Category: 14-under, 15-29, 30-49 and 50-up Address: _____________________________________ City: _____________ State: __________________ Email address: _________________________________ Phone number best reached at: ____________________ In appreciation of your support, your purchase entitles you to a 2015 Allegany Arc Membership. If you wish to opt out, please check here. Division (circle one): Kid’s Fun Run Men’s Walk Women’s Walk Men’s Run Women’s Run “I am able” (special needs) Waiver: In consideration of acceptance into the entry, I , the undersigned, for myself, my heirs, executors, and assigns to hereby waive and release any and all rights and claims for damages and injuries which I may have against the Allegany Arc, City and Town of Wellsville, Allegany Arc Board of directors, RaceWire Racing and all other parties involved with the event. In the event, I attest and verify that I am physically and mentally able to participate in and properly train for this event. Entrants under 18 years of age must have entry form signed by parent. Signature: Signature of Parent/Guardian (if under 18): Date: _______________________________________ _________________________________ ____________
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