1st Annual Apple Dumpling Festival 5K Run & Walk
Saturday, October 20, 2007 Stuart, Virginia "Slip on your running shoes and come take your place at our second annual 5K race!"
The Patrick County Junior Woman’s Club welcomes walkers and runners of all ages and abilities to the 1st Annual Apple Dumpling Festival 5K Run/Walk.
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Entry fees are as shown: Ages 16 and up$15.00
Ages 15 and under $12.00
Registrations mailed after September 15, 2006 or “on site” registration on the day of the race:
Ages 16 and up$20.00
Ages 15 and under $17.00
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MenWomen
15& Under15& Under
16-2216-22
23-2923-29
30-3630-36
37-4237-42
43-4943-49
50-5950-59
60 & Over60& Over
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Race day registration 7:30a.m. - 8:20a.m.
5K Race 8:30 a.m.
Post Race Awards 10:30 a.m.
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Medals will be presented to the 1st, 2nd and 3rd place finishers in each age group. Trophies will be presented to the top male and female finishers in the 5K. T-shirts will be given to participants until we run out. The awards ceremony will be held at 10:30 on the entertainment stage on Main Street during the Apple Dumpling Festival.
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Monies raised from this event will be donated to support the following projects:
-Supplies for Soldiers
-PCHS Scholarship
-PCHS Band Scholarship
-Christmas Cheer
-Lee National Denim Day
-Car Seat/Booster Seat Public Program
-Patrick County Developmental Center
Projects
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Parking will be available at Dehart Park which is where the start and finish lines will be located.
REGISTRATION
Print Clearly. Mail entry and payment to:
Patrick County Junior Woman’s Club
P.O. Box 106
Stuart, VA 24171
Name _________________________________
Phone _________________________________
Address ________________________________
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Email Address ___________________________
Age on race day ________ M or F
Please sign the waiver below and include with your registration information.
In consideration of my participation in the 1st Annual Apple Dumpling Festival 5K Run/Walk, I ______________________, (name of entrant) on behalf of myself, my heirs, legatees, personal representatives and all those claiming by or through me, consent to, and do hereby, discharge and release hold harmless the Patrick County Junior Woman’s Club, agents, servants, employees, assigns, successors, and heirs and any facility at which matches are held, from any and all claims, actions, losses, damages, or expenses for personal or bodily injury (including death) and property loss or damage of whatever the nature or cause, incurred by me or arising out of or in any way in conjunction with my participation in the aforementioned competition. In addition, I hereby consent to discharge and release the Patrick County Junior Woman’s Club from any liability whatsoever for the following: The Patrick County Junior Woman’s Club may use and reproduce my name, voice, likeness and any and all photographs, sketches and motion pictures taken or made of me, and/or my business premises, for any purpose whatsoever. I agree that the photographs, sketches, motion pictures and sound tracks taken or made of me, and/or my business premises, are the property of the Patrick County Junior Woman’s Club and I waive my right of inspection or review.
I am of legal age and capacity and have read and understand the contents of this Consent and Release.
Date: _____________________2007
Signature: _________________________________________
Parent/Guardian (if applicant is under 18):
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