The Race for Riley is a 5k walk/run created to raise awareness and funds for The Joseph Sams School. Come early for the run. Stay for the fun!
Saturday, April 24, 2010
5K Run/Walk - 8:30 a.m.
Bike Ride – 9:00am
1 Mile Run - 9:15 a.m.
Tot Trot - 9:30 a.m.
Circle one of the following:
RUN-------- 5K 1Mile Tot Trot
BIKE RIDE-- 10mile 30mile 60mile
PHANTOM - $25 (I can’t be there, but I support the cause; please mail my shirt to the address below)
RUN----- $20 by 4/16/10, $25 after 4/16/10 and on race day
RIDE---- $25 by 4/16/10, $30 after 4/16/10 and on race day
BOTH--- $40 by 4/16/10, $50 after 4/16/10 and on race day
Make check payable to: The Joseph Sams School
c/o Race for Riley
Name:
Age (as of race day): Sex: Male Female Address: City: State: Zip: Email: Phone: Date:
Signature: (If under 18, signature of parent / guardian)
T-Shirt size (circle one) YS YM S M L XL
WAIVER & RELEASE: I am in proper physical condition to participate in this event. In consideration of acceptance of this entry, I waive any and all claims for myself and my heirs against officials, volunteers, and/or sponsors of Race for Riley 5K/1 Mile/Tot Trot Run and 10/30/60 mile Bicycling event for any injury or illness which may directly or indirectly result from my participation. I grant permission to all of the foregoing to use any photographs, motion pictures, recording or any other record of this event for any legitimate purpose. I understand that radio/tape/CD headsets, dogs or other animals, in-line skates and skateboards are prohibited and that violation of this prohibition will result in disqualification. I understand the inherent risk of bicycle riding and agree to abide by all local highway, or other posted rules and further consent to wear an ANSI or SNELL approved bicycle helmet at all times while riding.
Print and Mail completed form and payment to:
Race For Riley c/o Race For Riley 280 Brandywine Blvd Fayetteville, GA 30214
Questions? Please call Waynette Peek at 770-463-0714. Or email at waynette@raceforriley.org.
