Branchport United Methodist Church

Living in Love and Harmony



Branchport United Methodist Church

3376 Guyanoga Road

Branchport, NY 14418

Thursday, July 4th, 2019 @ 8:00am


To Register Online visit:  


To register by mail, fill in the fields below, print out this form and mail this form and your check to the address below.

Print out one copy per entrant. Each participant, or their legal guardian, must sign the waiver at the bottom.


5K Cost – Please select one:

____   $25.00 pre-registration before June 30

____   $30.00 late/race day            

____   Kid’s Fun Run    FREE (t-shirts $10.00) – 1 mile race


Make checks payable to: Branchport UMC

Branchport UMC

c/o Dave Thorn

3988 Belknap Hill Road

Branchport, NY 14418


Race day registration/Check-in: 7:00-7:45am

Awards: Prizes will be awarded in age group categories for male and female top finishers.

Name: ___________________________________________________________________

Address: ________________________________________________________________

City: ___________________________           State: _____________________Email:  _________________________

Male: __________           Female: ____________    Age: ___________           Phone Number: ___________

Yes, I want a FREE  t-shirt – ____ S  ____M ____L ____XL (if registered by June 15th)

Total Cost ______ race fee 

Waiver: I know that running is a potentially hazardous activity that carries the risk of property damage, personal injury or death. I know I should not run this event unless I am medically able and I am aware of and assume all risks associated with running in this race. I understand that I, or the person(s) I am responsible for, will be subject to variable weather and course conditions.  I assume all risks associated with this event including, but not limited to, property damage, personal injury or death that may result from, including, but not limited to, personal medical conditions, falls, contact with other persons, traffic and road conditions. Therefore I, for myself, or the person(s) I am responsible for, release and hold harmless the Branchport United Methodist Church, The Upper New York Conference, and their representatives, all sponsors, agencies, municipalities and any other persons involved with the event, from any liability for any and all property damage, personal injury or death that may occur as a result of my/his/her participation in this event. I understand that my entry fee is NON-REFUNDABLE.      I also understand I may be photographed while participating in this event.


Signature: ______________________________________________________              Date: ______________


Parent or guardian must sign if participant is under 18 years of age.

United Methodist News

United Methodist News RSS Feed

19 May 2019

The latest news from the United Methodist News Service.

United Methodist Worship

Equipping Disciples | Discipleship Ministries

19 May 2019

The Equipping Disciples blog is a space for Discipleship Ministries staff and guest bloggers to offer inspiration and a unique perspective to growing disciples.