17th Annual Building Tomorrows 5K Run & Two-Mile Walk Saturday, April 25, 2015 Brookdale Park, Bloomfield, New Jersey Course Details: Double loop, park course, primarily shaded and all traffic free. USATF certified. Water stops. Split times. Schedule of Events: 8:00 a.m. - 5K Registration Opens 9:00 a.m. - 5K Kicks Off 10:00 a.m. - 5K Awards Ceremony 10:30 a.m. - Walk Registration Opens 11:30 a.m. - Walk Kicks Off 12:00 p.m. - Family Fun Fest Opens Age Groups: Awards: • • Entry Fees: • • • Runner: $30 (Early-bird rate $25 w/ code “EARLY” prior to April 19) USATF: $20 (Must submit 2015 USATF-NJ Membership #) Walker: FREE (Donations strongly encouraged) Results By: 14 & under through 85 & over: 5 years Amenities: Race/Walk T-shirts, Music, Giveaways, Refreshments, Interactive Family Fun For Directions: • • B-Tag scoring by Racewire 1, 2, 3 overall, male and female 1, 2, 3 age groups, male and female 473 Watchung Ave., Bloomfield, NJ 07003 OR 49 Bellevue Ave., Bloomfield, NJ 07003 (for accessible parking) For more information or to register online, visit www.walkorrun.org. 2015 Building Tomorrows 5K Run/Two-Mile Walk - Official Entry Form (one per entrant) Last Name First Name Street CityStateZip Gender Age (on race day) Date of Birth Email Address Phone # 2015 USATF-NJ # (if applicable) I am registering to (circle one): Run Walk Shirt Size (circle one): S M L XL XXL Payment Cash/Check enclosed Charge my (circle one): VISA MASTERCARD Credit Card Number DISCOVER AMEX Expiration Please make check’s payable to: The Arc of Essex County 123 Naylon Ave. Livingston, NJ 07039 CVV Waiver/Release: In consideration of this entry being accepted, I hereby for myself, heirs, executors and administrators waive and release any claims I may have against The Arc of Essex County, County of Essex, RaceWire, and any and all parties, groups, organizations, volunteers, sponsors and/or any representatives involved in the Building Tomorrows events for any and all injuries which I may suffer as a result of my participation in this event. I certify that I am physically able to participate in this event. I agree to abide by and cooperate with the race officials’ instructions and decisions. I understand safety is the top priority of this event; dogs, other pets, in-line skates, skateboards, bicycles, and similar devices are not allowed on the course; and my entry fee is non-refundable for any/all reasons including unavoidable event cancellation rescheduling. By providing my email address, I hereby authorize The Arc of Essex County and RaceWire to send me emails regarding this or similar events. I grant full permission use any photos, video recording, or other record of my attendance at this event for legitimate purposes without compensation or remuneration. I acknowledge that I have fully read this form, an fully understand the terms and conditions contained herein. Signature (parent/guardian signature if participant is under 18 years of age) Date Additional Questions? Contact The Arc of Essex County at (973) 535-1181 ext. 1227 or visit www.arcessex.org.