Pierce County High School

presents
1
st
Annual
Blue & Silver Challenge
5K and 1 Mile Fun Run/Walk
Run for Susan Brauda

Saturday, January 10, 2015
Blackshear, Georgia

5K Run at 8:00 a.m. 1 Mile Run & Walk at 9:00 a.m.


Location: Pierce County High School
4850 County Farm Road
Blackshear, GA 31516

Entry Fee: 5K -$20.00 Early Registration - $25.00 day of race
1 Mile -$10.00 Early Registration - $15.00 day of race

T-Shirts: All pre-registered 5K and 1 Mile Participants will receive a t-shirt. Shirts available to
entrants on race day as long as supplies last.

Awards: Awards will be given to Overall Male & Female Winners, Overall Male & Female
Masters, and top three finishers in each age group.

Information Robbie Spires
Contact: (912) 449-2055
rspires@pierce.k12.ga.us

***********************************ENTRY FORM***************************************
Blue & Silver Challenge 5K & 1 Mile

Name______________________________________ Age_____________ Phone (____)______________
Address_________________________________________________Birthdate_____________Sex______
City_____________________ State___________Zip____________
ADULT T-Shirt Size S M L XL XXL YOUTH T-Shirt Size XS S M L

I wish to enter the following event:
5K -$20.00; day of race-$25.00
1Mile -$10.00; day of race -$15.00

I assume all risks associated with participating in this event. I state that I am in proper medical condition to participate in this
race. In consideration of this entry, I, for myself and for my heirs against the event sponsors, their representatives, promoters,
and volunteers of the 1
st
Annual Blue & Silver Challenge or Pierce County High School or Pierce County Board of Education for
any injury or illness that may directly or indirectly result from my participation. I will abide by the event rules and exhibit good
sportsmanship. I also give permission for use of my name and picture in any media or other account of this event.


________________________________ ____________ ___________________________
Signature Date Parent or Guardian if under 18
Make Checks Payable to: Pierce County High School
Mail to: PCHS Blue & Silver Challenge
c/o Robbie Spires
4850 County Farm Road
Blackshear, GA 31516