3rd Annual Broad Rock Middle School
Crazy Coyote Chase 5K and 1-mile Fun
RACE DETAILS
AWARDS AND PRIZE DRAWINGS
Saturday, April 11, 2015 at Broad Rock Middle
School
>>> 1-mile Fun Run @ 9:00 am <<<
>>> Crazy Coyote Chase 5K @ 9:30 am <<<
Awards will be presented to
Complete and return the registration form (one per person, please) including entry fees payable to BRMS PTO—
please note “Crazy Coyote Chase”
in the memo section and mail to
Broad Rock 5K Committee
351 Broad Rock Road
Wakefield, RI 02879
http://br.skschools.net/pto/CCC
https://www.facebook.com/BrmsCrazyCoyoteChase
OR register online (small fee):
http://goo.gl/v8p4HA
Or with your smartphone —->>
 Top overall male and female finishers.
 Top three male and female 5K finishers in each age group
(15 and under, 16-19, 20-29, 30-39, 40-49, 50-59, 60-69,
70+).
 Top Broad Rock male and female student finishers in each
event.
 Raffle prizes and silent auction!!
SPONSOR A CHILD to run/walk in the 5K or the 1-mile fun run.
ASK about our family and group discounts (3 or more)!!
Race Day T-shirts guaranteed to first 200 registrants
KIDS CORNER—free on-site child care available for preregistered 5K participants. Kids’ Corner will be available from
NAME:
ADDRESS:
CITY:
STATE
ZIP
EMAIL:
PHONE: (
)
AGE:
GENDER:
PREFERRED T-SHIRT SIZE (ADULT SIZES ONLY): _____ S _____ M _____ L _____ XL _____ XXL
EVENT TYPE:
___ $20.00 > 5K ADVANCED REGISTRATION
___ $10.00 > 1MI FUN RUN REGISTRATION
___ $25.00 > DAY OF RACE REGISTRATION
___ $15.00 > 1MI DAY OF RACE REGISTRATION
___ I WOULD LIKE TO SPONSOR A CHILD TO RUN/WALK ___ $20.00 ___$10.00
ARE YOU A BROAD ROCK MIDDLE SCHOOL STUDENT? _____ YES, I AM IN _____ GRADE
KIDS’ CORNER RESERVATION: _____ YES ______ NO _______ # OF CHILDREN __________________ AGES OF CHILDREN
WAIVER: I assume all risks associated with participating in this event including, but not limited to falls, contacts with other participants, the effects of weather, traffic and
conditions of the roads, all such are being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, Broad Rock Middle School, BRMS PTO, Race Officials, the town of South Kingstown, SK Police and Fire Departments, Volunteers, and all Sponsors, their representative
and successors from all claims or liabilities of any kind arising out of my participation in the Crazy Coyote Chase 5K or 1 Mile Fun Run. I grant permission to all of the foregoing to use my photographs, motion pictures, recordings or any record of this event for legitimate purposes. Roller blades, and\or bicycles are not allowed to compete in
the race. Strollers or baby joggers are allowed in the 1 Mile event only. I hereby certify that I am physically fit and sufficiently trained for this event. NO RAIN DATE, NO
TRANSFERS, NO REFUNDS.
_________________________________________________________________________
________________________________________
SIGNATURE OF PARTICIPANT (parent or guardian if under 18 years of age)
DATE