VB Runway 5K Run/Walk Entry Form

To benefit Untamed Spirit and Wounded Warrior Project

November 22, 2014                                   Military Aviation Museum

1341 Princess Anne Road, Virginia Beach, VA  23457

 

RACE STARTING TIME:        Registration opens 7:30 a.m.  *5K Race begins at 9:00 a.m.  *½ Mile begins at 10:00 a.m.

RACE FEES:                        $25 by November 1, 2014                $30 November 1st thru race day

    $10 for ½ mile race

5K Run/Walk REGISTRATION:        Online registration at Race-it.com thru November 20, 2014 or mail by to:

    VBRunway 5K Race Coordinator, 2724 Renaissance Way, Virginia Beach, VA 23456

TIMING:                        Tidewater Striders

***In order to qualify for the ACE AWARD participants MUST register by November 1, 2014***

**RACE PACKET PICKUP WILL BE HELD SATURDAY, NOVEMBER 22 STARTING AT 7:30 a.m**

 

PAYMENTS:                        All checks are made payable to: UNTAMED SPIRIT

 

RACE CATEGORY:     5K Run             5K Walk        ½ mile                       

T-SHIRT SIZE:                    Adult:        SM     MED     LG     XLG                Youth:         SM     MED     LG    

               Women can choose either:     Unisex:    SM     MED     LG  XLG

                                                                        Womens: SM     MED     LG       

 

REGISTER PRIOR TO NOVEMBER 1st and T-Shirt size guaranteed, after November 1st size not guaranteed

 

AWARDS:        Awards will be given in 3 places by Male/Female age groups: 1-19, 20-29, 30-39, 40-49, 50-59, 60+

  Awards will be given to top 3 places Male/Female walkers

                Medals will be given to participants 12 and under who complete the ½ mile

                Ace Award given to those participating in BOTH events       

***In order to qualify for the ACE AWARD participants MUST register by November 1, 2014***

 For more information or if you have questions, contact: Jennifer Jeffers, Race Coordinator, at Jennifer@vbrunway5K.org

 

Participant Name: ____________________________________________________________ Sex: _____  Birthdate: ___________

Email: ____________________________________________________________________   Age on race day: _______________

Phone: _______________________________________                Emergency Contact: ______________________________

Address: _________________________________________________________________________________________________

 

WAIVER AND RELEASE:  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 run.  I assume all risks associated with participating in the VBRunway5K including, but not limited to, falls, contact with other participants, the effects of the weather, including high 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 release and knowing these facts and in consideration of your accepting my application, I for myself, and anyone entitled to act on my behalf, waive and release any and all sponsors, including, but not limited to, Untamed Spirit Therapeutic and Educational Program, the Military Aviation Museum, Tidewater Striders, race officials, volunteers and any and all sponsors, their representatives and successors from all claims and liabilities of any kind arising out of my/our participation in the event though that liability may arise out of our negligence or carelessness on the part of the persons named in this waiver.  I grant permission to all the foregoing to use any photographs, motion pictures, videos, recordings, or any other record of this event for any legitimate purpose, including newsletters and public relations materials.  I understand that this race is not intended for baby joggers, strollers or dogs.  Children under the age of 18 must have a Parent’s signature.

 

Signature of Runner: _________________________________________________________________  Date: ________________

Parent’s Signature for minor under 18: ___________________________________________________  Date: ________________

      

BENEFITING

UNTAMED SPIRIT THERAPEUTIC & EDUCATIONAL PROGRAM and WOUNDED WARRIOR PROJECT

501 (c) (3) non profit organizations