Jog 4 Jordan

Hosted by DECA Date: Saturday, October 5, 2013 Location: The Odessa High School Track. 713 S. Third St. Odessa, MO 64076 Race Time and Arrival Time: Race starts at 8:00 a.m. Race day registration and t-shirt pick-up begins at 7:00 a.m. Theme: Everyone is encouraged to come decked out in purple to show support of Jordan. Purple is her favorite color. 5K Fees: $20 including a free t- shirt. Race Day Registration $25. Deadline: September 23, 2013 to guarantee a t-shirt T- Shirts: Each pre- registered 5K race participant will receive a custom design commemorative t- shirt. T- Shirts are not guaranteed for late or race- day registrants. Limited supply of t-shirts will be available on race day. T- Shirt pickup will be on race day at the track. Course: Start at the Odessa High School track and follow the purple arrows. Timing: A big stop watch will be placed at the end of the race to tell you your time. Proceeds: All proceeds from this event will go to Jordan OMalleys family to help pay for her medical bills. Race Restrictions: Dogs, rollerblades, skates, skateboards, bikes or scooters are not permitted on the race course. However, strollers are welcome. Sponsors: Ultimate Image Fitness, Hair Mechanix, Bank of Odessa, Withrows Body Shop, Odessa Chiropractic Center, The Neighborhood Clinic, T&N Auto Parts, The Mixing Bowl Baking Co., Looks Unlimited

Waiver/ Registration Form

(This form is due on or before race day. All participants who don't have it filled out will be prohibited to race.) I know that running is a potentially hazardous activity. I should not enter or run this event unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risks associated with running in this race including, but not limited to, falls, contact with other participants, the effects of weather, including high heat and/ or humidity, the conditions of the road and traffic on the course, all such risks being known and appreciated by me. All fees are nonrefundable. Race will take place rain or shine. In the event of extreme weather conditions or some other unforeseen act of God that may prohibit the race, all fees are nonrefundable. Having read this waiver and knowing these facts, and in consideration of your acceptance of my application, I, for myself and anyone entitled to act on my behalf, waive and release the event, and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. Registration will not be accepted without acknowledgement of waiver signature: Signature: Date:

If 17& under parent signature is required as well Parent signature: First Name: Email: Phone: T-Shirt Size: S___ M____ L___ XL____ 2XL___ Last Name: