2nd Annual Indian Nation 5K & 1 Mile Fun Run Saturday, April 25 • 9 a.m. Biloxi City Hall Both races are open to the public, water available on course, drinks and snacks after race—costumes encouraged! Pre-Race Registration Late Registration (after Apr. 22) •$10 Adults, $5 Students by Apr. 22 •$15 all entrants •2 for $15 (forms must be turned in together) •Must sign up by 8:30 a.m. •Check-In/Late Registration at 8 a.m. •Forms available at biloxischools.net 1-MILE Prize Money, Male and Female 1st Place $100 • 2nd Place $50 • 3rd Place $25 5K Awards, Male and Female Top 3 Overall • Top 3 in the following age groups: Elementary, Jr. Hi, HS, 20-29, 30-39, 40-49, 50-59, 60+ Name:___________________________________________________________________________________ Sex:________ Race Day Age:_________ Phone:_______________________________________________ Please Check Student group: □ Elementary □ Jr. High □ High School Please Check Adult group: □ 20-29 □ 30-39 □ 40-49 □ 50-59 □ 60+ Please check your school: □ BHS □ BJHS □ Gorenflo □ Jeff Davis □ Lopez □ North Bay □ Popp’s Ferry Please check T-shirt size: □ Youth Small □ Youth Medium □ Youth Large □ Adult Small □ Adult Medium □ Adult Large □ Adult XL □ Adult XXL Adult Long Sleeve Available for extra charge of $5: □ Long Sleeve Adult S □ Long Sleeve Adult M □ Long Sleeve Adult L □ Long Sleeve Adult XL □ Long Sleeve Adult XXL WAIVER: I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the race. I assume all risks associated with running in this event including, but not limited to: falls, contact with other participants, the effects of the weather including heat and/or humidity , traffic and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the Biloxi Public Schools and all sponsors, their representatives and successors from all claims for liabilities of any kind arising out of my participating in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recording or any other record of this event for any legitimate purpose. And I agree that all decisions of the race committee are final. Signature (parent if under 18)_______________________________________________________________________ Date:_____________________________________ Make check payable to: Biloxi Band Boosters (checks are non-refundable) Mail to: Indian Nation 5K, 160 St. Peter Street, Biloxi, MS 39530