Saturday, April 18, 2015 A family-friendly, neighborhood run! Entry Fees 1 mile: $20 until 4/12 ($25 on race day) 5k: $25 until 4/12 ($30 on race day) RWTW tech shirt only, not running: $15 Sponsor a youth runner: $5 donation Pre-registration: until Sunday 4/12/15 at http://atlncs.org/5k Race-day Registration: 7:15am - 8:05am 5K run/walk: 8:15am; 1 Mile: 9:00am Location: Atlanta Neighborhood Charter School (ANCS) Middle School 820 Essie Ave., Atlanta, GA 30316 (in Ormewood Park) Awards: Presented to top finishers in multiple male and female age groups; all pre-registered runners receive a race shirt How to Register Make check payable to ANCS PTCA Mail completed entry form(s) and check to: Kerrie Hall, ANCS Elementary Campus 688 Grant St. Atlanta, GA 30315 Turn in form in front hall, Attn: Coach Hall Go to http://atlncs.org/5k to register online until 4/12/15, 11:59pm Blue Wolf: The SHED White Wolf: Red Robin Group Cub: The Body Well Honeysuckle Gelato JavaVino Last Name First Name 5k Tech Shirt Only, Not Running 1 Mile Sponsor a Student YS YM YL WXS WS WM WL WXL WXXL MXS MS MM ML MXL MXXL Circle Shirt Size (Youth, Women’s, or Men’s) Age (on 4/18/15) Male Female Running with Stroller (5K only) ANCS Classroom/Advisory or Group Running With (if applicable) Address Friends of RWTW: City, State and Zip Email Phone Participant’s Signature or Signature of Parent/Guardian for Minor * Date * Waiver: In consideration and acceptance of this entry form for the 2015 ANCS Run with the Wolves event, I hereby waive any and all claims for myself, the minor, and my heirs and assigns against the sponsors, officials, and directors of the event for injury or illness which may result from my participation or participation of the minor in the event. Minor Medical Waiver: I hereby authorize any licensed physician, emergency medical technician, hospital or other medical or health care facility to treat the minor for the purpose of attempting to treat or relieve any injuries received by the minor from participating in the event. I authorize all procedures deemed medically advisable in attempting to treat or relieve such injuries. I acknowledge that no warranty is being made as to the results of any medical treatment. I authorize the use of mine or the minor’s image to be used in materials promoting the Run with the Wolves and/or ANCS. For ANCS students needing entry fee scholarships, please contact Ms. Dennis or Ms. Larson. More info: http://atlncs.org/5k Contact us: [email protected] PTCA
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