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2nd Country Day 5k - Union, MS

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2nd Annual Country Day 5k
2nd Annual Country Day 5k
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2nd Country Day 5k - Union, MS

  1. 1. Union’s Country Day 5K Run/ Walk Kids’ 1 Mile Fun Run Saturday, August 24, 2013 Race Day Registration: 5K Run Awards Race Start Time: 7:30 a.m. Start Location: Truhitt’s Texaco Service Station, 109 East Jackson Road/ Hwy 492 All Participants will receive a T-SHIRT! Refreshments (Cold drinks and snacks) will be provided to all participants at the finish. Registration: Registration Fee: $20 Runners will be allowed to register up until race- day with a fee of $25. You may pre-register by mailing in the registration below and personal check to the following address: Please Note: All personal checks must include Cell number and Driver’s License Number. Payable to: Union Chamber of Commerce P.O. Box 90 Union, MS 39365 Entry Form Union’s Country Day Run 5K Run/Walk Kids’ 1 Mile Fun Run Saturday, August 24, 2013 NAME__________________PHONE (___)________-________________ MALE______FEMALE_____ ADDRESS___________________________ CITY___________STATE______ZIP CODE___________ E-MAIL: __________________________________________________________________________ Please select one: 5K Run _________ 5K Walk________ Kids’ 1 Mile Fun Run ___________ T SHIRT SIZE (Circle one) Small, Medium, Large, Extra- Large, XX-Large Participant Waiver and Release I waiver any and all claims for myself, my heirs, and assigns, against Union Chamber of Commerce, all race co- sponsors and town of Union, and subsidiary or political subdivision thereof, it or their representatives, successors, and assigns for injury or loss which may result directly or indirectly from participation in this event. I further state that I am in proper physical condition and have trained for completion of this event. Further, I hereby grant full permission to any and all of the forgoing to use any photographs, videotapes, or any other records of this event for any purpose whatsoever. No refunds. Age: _______ Signature:_____________________________ Date:_________________________________

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