Vous êtes sur la page 1sur 1

St.

Josephs Church
nual
10th
A n
5k Run/Walk
Saturday June 3, 2017 INFO
Registration 7:15 AM-Race Begins 8:00 AM
St. Joseph Catholic Church Parish Center Discounted Entry fee for Age
12 and under or without race
Jasper, IN
t-shirt
Entry fees: Register by May 17th for discount
Automated Timing system
$10 Age 12 and under

$10 Preregistered Runners/Walkers No t-shirt FREE post race refreshments

$15 Preregistered Runners/Walkers With t-shirt Many great Attendance Prizes


$5 Additional for All Participants after May 17th
$50 CASH Awards for Top
Adult Male and Female
The St. Joseph Church 5k Run/Walk is hosted in conjunction
with the churchs annual Summer Picnic.. Make plans to join
us for a morning of fun, fitness and fellowship by completing
Trophies for Overall 12 and
and mailing the attached entry form. Or register online using under Male and Female
the address listed below (additional processing fee).
Participation prize for all age
Mail form and entry fee to: 12 and under participants
Audrey Werner For more information please contact:
526 E. Burger Rd.
Jasper, IN 47546 Audrey Werner: 812.482.7257

Make checks payable to Additional flyers may be found at


St. Josephs Catholic Church www.saintjosephjasper.org
Name Waiver: I, for myself, my minor child (if applicable) my administrators, heirs and
assigns, do herby release, waive, and forever discharge the Bishop of the
Catholic Diocese of Evansville, St. Joseph Catholic Church, Fr. Ray Brenner
Address Pastor, and any of their respective affiliates, successors, agents, employees,
members, and representatives, adult sponsors, and any other volunteers
involved in this run/walk and the City of Jasper, its boards, elected and
Phone appointed officials and its employees, from any and all claims, including claims
of property damage and personal injury, including death, that may arise or grow
Email (for results) out of my participation or my minor childs participation in the St. Josephs Run/
Walk. I also agree to indemnify and hold harmless the City of Jasper, its boards,
elected and appointed officials, and its employees in any claim, damages,
expenses or action, including attorney fees, assessed or brought against them
Male Female Age on race day
because of my acts or omissions or the acts or omissions of my minor child. I
certify that I have prepared for this event and am in adequate physical condition
T-Shirt : Yes No ( note difference in entry fee )
for this event. I agree to follow rules of the run/walk, obey all traffic laws, avoid
If YES, Circle size: Youth SM Youth MD Youth LG littering, and respect the property of others.

Adult SM Adult MD Adult LG Adult XL


Signature: Date: Signature of guardian if under 18: Date:

Register online at https://runsignup.com/Race/IN/Jasper/StJosephsChurch5Krunwalk