nu 6t h al

Watsontown JesVic 5K
In loving memory of Jessica Wade and Vicki Hitesman Supporting local families facing disease and medical bills
of is providing full funding for

Ra Wa ce & lk

An

Date: Saturday, June 2, 2012 Time: 5K at 9 a.m. Kids 1/2-mile starts around 10 a.m. 5K registration closes at 8:45 a.m. Place: Watsontown Elementary School 1100 Main Street, Watsontown, PA

American Legion
Watsontown Post 323
Awards
Top three overall nishers, top three in each age group, and the top masters nishers are awarded. Age Groups: 14 and Under 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70 and Over

Chip Timing from PA Runners!

Kids 1/2-Mile Race

Must be 12 and under All participants receive a ribbon. Top three boys and Top three girls of each age group awarded: 8 and Under 9-12

Registration Instructions
Option 1: Pre-registration 5K $15 Kids 1/2-mile $10 Must be received by May 25. Family rate: Families of four or more preregistered members = $10 each member. All registration forms must be mailed together. Option 2: Race-day registration 5K $20 Kids 1/2-mile $15 Race-day registration is open from 7:15 a.m. until 8:45 a.m.

Make checks payable to: Watsontown 5K

Mail check or cash and completed form to: Watsontown JesVic 5K Kipton Hoffman 4 Whitetail Lane Watsontown, PA 17777

Questions? JesVic5K@gmail.com & http://jesvic5k.org

Like us on Facebook at JesVic. Follow JesVic5K on Twitter.

Name (First, Last): ____________________________________ Address: ___________________________________ ___________________________________ Event: 5K run S M 5K walk L XL Kids 1/2 mile XXL T-shirt size:

Gender:

Age on race day: _______ Email: _______________________ No Thanks

JesVic offers daycare services starting at 8:30 a.m.. Please pick up your children by 9:45 a.m. If bringing children for daycare services, how many can we expect? _________
REQUIRED WAIVER: I understand that a race is a potentially hazardous activity. I know that I should not enter unless I am medically capable and properly trained. I assumed all risks associated with participating in this event. I release any and all claims against the event organizers and volunteers, and the town of Watsontown and its employees. I also permit race organizers to use photos and/or videos of my likeness captured at the JesVic 5K for advertising purposes.

______________________________________________________________________________ Signature (If under 18, please have guardian sign instead.) Date

Watsontown JesVic 5K
In loving memory of Jessica Wade and Vicki Hitesman Supporting local families facing disease and medical bills