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SpeedReadRegistration2012FINAL PDF
SpeedReadRegistration2012FINAL PDF
SpeedReadRegistration2012FINAL PDF
PU
CL B LI
IBRARY S
PE E
D
5 AD RE
JEFFE
RS O
SPEED READ 5K
Saturday, December 1, 2012 1K Junior Jog Begins 1:00 PM 5K Race Begins 1:30 PM Walkers Welcome!
DE
Location:
CEM
01 B E R 1, 2
2
Registration:
Detach and mail in registration form below by November 26 Make checks payable to Friends of the Library Race Day Registration begins at 12:00 Noon
Entry Fees:
Awards:
Pre-registered: $15 Race Day: $18 Family: $40 (pre-registration max up to 4 family members) Additional Family Members $6 with Family Registration Runner Only (no shirt) $10 pre-registered, $15 Race Day
Top male & female overall, top male & female masters, top 3 male & female finishers in 15 age groups: 10 & under 11-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75 & over
T-Shirts:
% entry per person. Do not mail after November 26, 2012 One
Send payment to Friends of the Library c/o Jefferson Public Library 379 Old Pendergrass Road, Jefferson, GA 30549
Last Name__________________________________________First Name______________________________________ Address_____________________________________________City_______________________State_____Zip________ Phone_____________________________E-mail_______________________________________Age______Sex_______ 100% Cotton Adult T-shirt Size: S_______M_____L_______XL______Youth L_____ 2X (add $2.00)________
In consideration of acceptance of this entry, I waive any and all claims for myself and my heirs against officials and sponsors of the 2012 Jefferson Public Library Speed Read 5K Road Race for illness or injuries which may result, directly or indirectly from my participation. I further state that I am in proper physical condition to participate in this event. Signature___________________________________________________________Date___________________________ Under 18 Parent Signature___________________________________________________________________________