Branchport United Methodist Church

Living in Love and Harmony

RED, WHITE, BLUE 5K WALK / RUN 2018

 

Branchport United Methodist Church

3376 Guyanoga Road

Branchport, NY 14418

Wednesday, July 4th, 2018 @ 8:00am

 

To Register Online visit: https://runsignup.com/Race/NY/Branchport/RedWhiteBlue5kWalkRun

 

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.

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Taylor Burton-Edwards – Equipping Disciples | Discipleship Ministries

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