First Annual Run for the Warriors Fundraiser to benefit Averill Park Indoor Track and Friends of Algonquin Athletics 5K Run/3K Walk Sunday, May 17, 2015 9:00 a.m. Algonquin Middle School, Averill Park Runners and walkers of all ages and abilities are welcome Show your Warrior pride by wearing blue and gold Find us on Facebook: Run for the Warriors 5K Packet pick-up day of run beginning at 7:30 a.m. Awards to top three overall male and female finishers and top male and female by age group $25 Race Registration (must be received by May 10) $30 Day-of Registration http://aprunforwarriors.weebly.com (for information and online registration) Please make checks payable to: Algonquin APO. Send form and check to: Ms. Ann Lanoue, Run for the Warriors, Algonquin Middle School, 333 Route 351, Averill Park NY 12018. Forms with payment must be received by May 10. Name _____________________________________________ T-shirt size: Address ____________________________________________ T-shirt guaranteed for registrations received by May 1. City __________________________ ST ______ ZIP__________ Age _______ Sex _______ Email________________________________________ Event: Adult: S M L XL XXL __5K Run Phone______________________ __ 3K Walk $25 Race Registration ($30 Day of Registration) Registration Cost: ______ I would like to make an additional contribution of: $5 $10 Other: _____ Total enclosed: _______ In consideration of accepting this entry for myself or for the person that I am registering, I, the undersigned, intending to be legally bound hereby, for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I may have against this event, all towns/cities it occurs in, the event staging facilities, and any sponsors, as well as any person involved with this event. I fully understand that I, or the person I am responsible for, will be subjected to roads and trails that may have uneven terrain, rocks, roots, and other obstacles, but that I am physically fit and have sufficiently prepared for this race. My physical condition has been verified by a licensed medical doctor. I hereby grant full permission for the event to use any photos, videos, or any other record of this event for any purpose whatsoever. Furthermore, I understand that my entry into this event is NON-REFUNDABLE and that no refunds will be issued regardless of reason, which includes even if the event is not held. Signature____________________________________________ (if under 18 Parent/Guardian must sign)
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