Run 4 Recovery In Memory of Harry David Rankin

Saturday, September 28, 2013 at 9:00 a.m. Ft. Mitchell, Kentucky

Join us on Saturday, September 28, 2013 at Blessed Sacrament Church, 2407 Dixie Highway, Ft. Mitchell, KY for a 5K Run/Walk to benefit The Grateful Life Center, our local, in-patient rehabilitation center which provides free treatment for men who are recovering from the disease of drug or alcohol addiction. Hundreds of lives have been saved by this program.
Course: Awards: Scenic 3.1 mile race on paved paths through beautiful Highland Cemetery and old Ft. Mitchell. First and Second place awards will be given to the top two male runners and walkers and to the top two female runners and walkers in each age group. Door prizes will be awarded after the race from random drawings of race bib numbers. Participants must be present at the Awards Ceremony after the Race to claim their prizes. Pre-Registration: Online Registration: $30.00, which includes a long-sleeved Race T-shirt. Mail-in registration must be postmarked by September 21, 2013. Online registration ( www.sprunning.com) until September 25, 2013.

Race Day Registration: $35.00. A long-sleeved Race T-shirts will be included while supplies last. Race Day Registration opens at 7:30 a.m. Pre-race Pick Up: Tri-State Running, Erlanger Kentucky, Friday September 27 10a-6p or 7:30 race day

Race for Recovery 5K Run/Walk

First Name: _________________________________ Last Name: ______________________________________

Address:________________________________________ City: _______________ State:____ Zip Code:_________ E-mail: _____________________________________________________ Phone: (____)______________________ Sex: Male____ -orFemale______ Division (circle ONE): 5K Run -or5K Walk

T-Shirt Size: S M L XL XXL - add $10 to registration for XXL size Make checks payable and mail form to: The Grateful Life Foundation c/o Holly Daugherty Ferguson, 463 Commonwealth Avenue, Erlanger, KY 41018. Waiver: In consideration of the acceptance of my entry, I hereby waive, on behalf of my heirs, executors and assigns, all claims of any nature arising from my participation in the Race for Recovery 5k Run/Walk and do hereby release Steve Prescott, all sponsors, workers, officials and volunteers from any claim whatsoever arising from my participation in this event. I agree to abide by all the rules of participation and acknowledge that the Race Committee may refuse or return my entry at its discretion. I understand the risks for such a activity and have trained adequately in preparation for the activity. I HAVE NOTED ANY MEDICAL CONDITION on this form next to my signature. I authorize the use of my name, likeness and photograph for any public or private usage resulting from my participation in this event. I understand that this event is not sponsored by The Grateful Life Foundation or Transitions, Inc..

Signature: ________________________________________________________________________________________ Relative medical conditions: ____________________________Emergency Contact______________________________ Parent Signature (if under 18): _________________________________________________________________________ _______________________