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17th Annual Shamrock Walk and Run
(http://www.rockwalkrun.com/)
2010 Shamrock, Walk, Run & Jog With Your Dog
Sponsored by: Friends of the Library
March 13, 2010
Event Details
The event will feature a 5k run, 2-mile walk, 1-mile jog with your dog and children’s races.
Live entertainment, vendors, and family activities will also be featured.
Event Times
1:00 p.m. Day of Registration/Packet Pickup; 2:00 PM Kids Races (7 & Under); 3:00 PM 5k Run; 3:15 PM 2 Mile Walk; 4:00 PM 1 Mile Jog With Your Dog.
Fees
5K or 2 Mile $18 thru 3/10/10, $25 thereafter----- 1 Mile Jog With Your Dog $18 thru 3/10/10, $25 thereafter----- 5K or 2 Mile walk with Jog With Your Dog $30 thru 3/10/10, $35 thereafter----- Kids Races $5 thru 3/10/10, $7 thereafter
Additional Information
For additional information or to register online please visit www.rockwalkrun.com. Additional information may also be obtained by calling the Winter Haven Public Library at (863)-291-5890.
This event is a fundraiser for the Winter Haven Public Library Children’s Department.
2010 Entry Form
Please bring or mail the completed form to: Children’s Department c/o Winter Haven Public Library, 325 Ave A. N.W. Winter Haven Florida, 33881. Phone: (863)-291-5890.
Please submit separate entry forms for each participant.
Last Name: First Name: MI: _____
Address: City/State/Zip:
Phone: Email:
Age on Race Day:
Choose One (Circle One): Male Female Clydesdale (200 lbs. Men)
Event (Circle One): 5k Run 2-Mile Walk Kids Races 1-Mile Jog with Your Dog
T-shirt Size (Circle One): Adult – S M L XL Youth – S M
Amount Enclosed (See fees above):
Waiver and Release (Signature Required Below)
In consideration of my entry being accepted, I intend to be legally bound and do hereby for myself, my heirs and executors, waive and release all rights and claims for damages which may here after accrue to me against the City of Winter Haven, Winter Haven Public Library, the Friends of the Library, any race officials and volunteers, and any race sponsors and their respective officers, agents, representatives, successors and assigns from any cause, including negligence or carelessness. Further, in the event that I am signing this application on behalf of my minor child, I hereby agree to hold the above-mentioned parties harmless for any injuries that my minor child may receive in conjunction with this event. If I or my minor child should suffer any injury or illness, I authorize the officials of this event to obtain medical treatment for such injury or illness or transportation to a medical facility, with their discretion and I take full responsibility for this action. I verify that I (or my minor child) is physically fit and are able to participate in this rigorous athletic event. FOR ALL PARTICIPANTS ENTERING WITH A DOG: All participants entering with a dog must abide by the City of Winter Haven regulations. All dogs must be on a leash, have current tags and had a rabies shot within the last twelve months. Owners are solely responsible for the actions of their dog(s). Only one dog permitted per person.
Signature: Date: |
