Westside Elementary
School’s 3rd Annual
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Finish line services presented
by A Course/Line, LLC of Valdosta
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“Cinco K & 1 Mile Fun Run on Quatro de Mayo “
5K Run/Walk & 1
Mile Fun Run
Saturday, May 4,
2013
7:00 am
Registration/Packet Pick-Up
8:00 am 5K
Run/Walk; 9:00 am 1 Mile Fun Run
*Award Ceremony
immediately following the 1 Mile Fun Run.
Entry Fee
$15.00/Adult and $10 Child (includes t-shirt & medal for 1 milers)
$50 Maximum/Family
Discount (includes
parents and children under 18)
*Please make checks
payable to WES PTO.
**Pre-registration
deadline is Tuesday, April 30, 2013 (required for t-shirt on race day).
Race will begin and
end at Westside Elementary School
2470 James Road, Valdosta,
Georgia 31601.
Awards will be
presented to the overall male and female in each race and to the top 2 male and
female participants in each age group.
All
proceeds will benefit Westside Elementary School’s PTO. No refunds.
………………………………………………………………………………………………….
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Gender
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Age(5/4/13)
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Circle One
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Circle t-shirt
size
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1.Name:______________________
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M/F
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_________
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5K 1 Mile
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YS YM YL AS AM AL
AXL A2X(add $2)
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2.Name:______________________
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M/F
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_________
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5K 1 Mile
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YS YM YL AS AM AL
AXL A2X(add $2)
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3.Name:______________________
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M/F
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_________
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5K 1 Mile
|
YS YM YL AS AM AL
AXL A2X(add $2)
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4.Name:______________________
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M/F
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_________
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5K 1 Mile
|
YS YM YL AS AM AL
AXL A2X(add $2)
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Address:__________________________________________________ Email:______________________________________
City:__________________________________ State:__________ Zip:____________ Phone:_________________________
For
and in consideration of my being allowed to participate in the Viking Run
(hereinafter “the event”) and on behalf of myself, my heirs, personal
representatives and assigns, I hereby assume all risks and waive all claims for
injury or illness which may result, directly or indirectly, from my
participation in the event and agree to indemnify and hold harmless the Lowndes
County Schools, Westside Elementary School, sponsors, organizers, and their
respective employees, claims, including attorney’s fees, which may at any time
be incurred by reason of my participation in the event. I understand that anyone entering this race
who is not adequately trained is taking a definite risk in suffering physical
ailments. I do herby state that I have
trained properly and that I am physically prepared to participate in the event,
and I expressly assume the risk of any illness or injury which may result from
my participation in event.
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1._______________________________Date________
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2._______________________________Date________
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3._______________________________Date________
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4._______________________________Date________
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(Signature of
entrants or parent/guardian if entrant is under 18)
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