Proceeds go to PTAs in Fayette Co.

Public Schools

$10 for Pre-Registered Kids up to 18

(before 10/01/16)

Register online at:

$20 for Pre-Registered Adults

(before 10/01/16)

$25 ($15 for kids) after 10/01/16

$25 for all on Race Day

www.PTA5K.com

- PTA 5K Training
- Kids Marathon

Awards T-Shirts Family Fun

Sponsored by:

Questions:
Jesi Bowman
www.PTA5K.com
infoPTA5K@gmail.com

Checks made out to:

16th District PTA

Mail form and fee to:

16th District PTA 5K

c/o Liz Hill
303 Curtin Dr.
Lexington, KY 40503
$10 Kids up to 18 by Oct. 1

Email
Phone
School PTA to benefit
Choose ONE:

1 mile FUN RUN

$20 for Adults by Oct. 1
$25 ($15 for kids) thereafter
and $25 for all on Race Day

Waiver: In consideration of the acceptance of my entry, I for

myself, my heirs, executors, and administrators, do hereby release
and discharge the 16th District PTA, 16th District PTA Board
Members, and all sponsors, volunteers, and associates of this
event from any and all claims in said event. I certify that I have full
knowledge of the risks involved in participating in this event, and I
am physically fit and sufficiently trained to participate in this event.
I also release publishing rights of photographs of me taken during
The PTA 5K Run/Walk, or 1 Mile Fun Run/Walk, for purposes of
publicity for this event.

Name

PTA 5K

Choose ONE:
PTA 5K Training Program
Kids Marathon Program

Donation _______________

T-Shirt: YM

YL AS

TOTAL:_________________

Sex:

COUPON CODE:

_______
AM AL

AXL AXXL

Birthdate

Signature

Date

Signature of parent or guardian if

under 18 years of age.

Date

AXXXL

Destinarn al PTA en las escuelas pblicas del

Condado de Fayette.

Register online at:

www.PTA5K.com

$10-para nios preinscritos hasta 18

(antes de 01/10/16)

- PTA 5K programa
de entrenamiento
- Maratn de nios

$20-para adultos registrados previamente

(antes de 01/10/16)

$25 ($15 para nios) despus de 01/10/16

$25 para todos en el da de la carrera

Premios Camisetas Diversion

Patrocinado por:

Preguntas:
Jesi Bowman
www.PTA5K.com
infoPTA5K@gmail.com
Cheques a nombre de:

16th District PTA

Mail form and fee to:

16th District PTA 5K

c/o Liz Hill
303 Curtin Dr.
Lexington, KY 40503
10 para ninos up to 18 by 1/1016
20 para adultos by 1/10/16
25 - (20 para nios) despus de
1/10/16 y 25 para todos en el
dade la carrera

Donacion _______________
TOTAL:_________________

Renuncia: En consideracin a la aceptacin de mi entrada, que para m,

mis herederos, ejecutores y administradores, por la presente suelte y
descarga el PTA distrito XVI, 16 miembros de la Junta de distrito PTA y
patrocinadores todos, voluntarios y colaboradores de este evento de
cualquier y todo reclamo en dicho evento. Certifico que tengo pleno
conocimiento de los riesgos de participar en este evento, y estoy bien
fsicamente y suficientemente entrenado para participar en este evento.
Tambin quiero liberar derechos de publicacin de fotografas mas
tomadas durante la PTA 5K Run/Walk, o diversin 1 mile Run/Walk, para
propsitos de publicidad para este evento.

Nombre
Email
Telefono
PTA para beneficiarse de
Choose ONE:

1 mile FUN RUN

PTA 5K

Choose ONE:

COUPON CODE:

PTA 5K programa de entrenamiento

_______

Firma

Fecha

Maratn de nios

Camiseta: YM
Sex:

YL
F

AS

AM AL

AXL AXXL

Fecha de nacimiento

AXXXL

Firma del padre o tutor si es menor de 18 aos de edad

Fecha