COLORS OF HOPE 5K WALK/RUN
Saturday, May 16, 2015
Registration at 8:30 am
Race starts at 10 am
Being held at the Hess Field Pavilion
Registration form:
Name: __________________________________________
Age (at race date)/gender: _____________________________
Address: ________________________________________
City, State, Zip: ___________________________________
Phone ( ) - _______ - ________
Emergency Contact (name and phone number): ____________________________________
T-Shirt size(s): ________________
Entry Fee: Please make your check payable to the American Cancer Society, 1948 East Third Street Williamsport, PA 17701. Return form and fee to: Kayla James at PO Box 82, Danville, PA 17821. Any questions contact Kayla at kaylah0228@yahoo.com.
- Registration before April 24 (includes T-shirt): $20
- Registration on or after April 24 (T-shirt not included): $25
- Children 12 years old and younger: free
Disclaimer: For and in consideration of permission to participate in this race, I for myself, my heirs, executors and administrators, do hereby release and discharge the sponsors, contributors, officials, employees and all of the members and officers of the American Cancer Society, Relay For Life, the borough of Danville, PA, from all claims and damages arising from my participation in this race. I attest and verify that I am physically fit and have sufficiently trained for this event.
Signature/Date: ________________________________________________________
(Parent Signature if under 18)
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