REGISTRATION FORM

The First Annual

Wildcat Jingle Jog 2017

2 Mile Run *and* 1 Mile Fun Run/Walk
A senior project fundraiser for the Schley County High School Cross Country and Track Teams

Friday, December 1st

Fun Run/Walk @ 6:00 PM & 2 Mile Run @ 7 PM
Check in by 5:30 @ the park-downtown Ellaville

Come support the Schley County XC/Track Teams!

Registration forms may be picked up at Schley County Middle High School, Schley County Elementary School,
Ellaville Floral Shop, and Gill Drugs. Forms and entry fees may be turned in to the SCMHS office, SCES office,
or at the registration table on race day. Checks can be made payable to Schley County High School with
XC/Track Team Fundraiser on memo line.

1-Mile Fun Run/Walk Registration Fee -- $10 by November 17th ($15 day-of)

2-Mile Run Registration Fee -- $20 by November 17th ($25 day-of)

**Register on Back of Form**

 Wildcat Jingle Jog 2017 Registration

Name: ________________________________________ Age (as of December 1st): ________

Address: _____________________________________________________________________

Email Address: _______________________________ Phone Number: ___________________

Event (circle): *2-Mile *1-Mile Fun Run/Walk

T-Shirt Size (circle):

Youth Small Youth Medium Youth Large Small Medium Large XL

*Everyone who registers by Friday, November 17th will receive a Wildcat Jingle Jog T-Shirt

*Awards will be presented in each age group. All ages welcome. All kids 10 and under will receive a medal.

WAIVER: I know that running or walking this 2 mile and/or 1 mile run/walk is a potentially hazardous activity. I should not enter and
run or walk unless I am medically able to do so. I assume all risks associated with participating in this event including, but not limited
to, falls, contact with other participants, the effects of the weather, traffic, and the conditions of the course, all such risks being known
and appreciated by me. I, for myself, and anyone entitled to act on my behalf, waive and release all sponsors, their representatives and
successors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all the foregoing
to use any photographs, motion pictures, recording, or any other record of this event for any legitimate purpose.

SIGNATURE: ___________________________________________________________
Participant or Parent/Guardian of Participant (if under 18)