Wilson 5K Sign-Up

Wilson IM ABLE 5K &

Last Chance Egg Hunt (ages 10 and under)

“RUNNING OUT LOUD”

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When:  April 3rd, 2016 Rain or Shine
Registration: Starts at 9:00AM
Race Time: Handcyclists: 9:55 AM | Walkers/Runners: 10:00AM
Where: Wilson West Middle School, Sinking Spring PA
Race Cost: Students:  $20.00 | Adults: $30.00
Egg Hunt (10 and under):
Immediately following the 5K and free with adult entry!

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WHAT YOUR PARTICIPATION MEANS: All proceeds from the race and sponsors will go towards helping a local child get the gift of physical activity. Prior to the start of the race, we will present a Hase Recumbent Trike to Emily Mitchell, a 5th grader at Green Valley Elementary School.
SPONSORSHIP: Race sponsorship opportunities available.  Please e-mail Dave Noyes at dave@imablefoundation.org.

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PLEASE FILL OUT THE FOLLOWING REGISTRATION FORM TO ATTEND

* If you would like to mail in the form, please Download the Registration Form in PDF Format.

Registration accepted until March 25, 2016. After that you must register at the race.
A limited amount of shirts will be for sale on the day of the run.
Make TAX DEDUCTIBLE Checks Payable to IM Able Foundation ‐ Wilson Chapter

Please mail payment to:
Wilson High School
Attn: Dave Noyes
IMAble Club
2601 Grandview Blvd
West Lawn, PA 19609

PARTICIPANT NAME*:

EMAIL ADDRESS*

PARTICIPANT WILL BE:
Runner/WalkerHandcyclist

AGE*:

GENDER*

MaleFemale

SHIRT SIZE*

(*T-shirt guaranteed if registration received by March 11th, 2016.
Please do not mail registration after March 25. (Please register the day of the race))

SHIRT CUT*

MaleFemale

CHILDREN PARTICIPATING IN EASTER EGG HUNT
Name: Age:
Name: Age:
Name: Age:
Name: Age:

WAIVER: I understand that participating in a 5K could be potentially hazardous and that I should not enter unless I am medically able and properly trained. I also acknowledge that some of the footing on the course may be poor, and I assume the risk of running on it. I also assume all other risks associated with running this race including but not limited to falls, contact with other participants, the effects of weather, and the conditions of the course. Knowing these facts and in consideration of your acceptance of my entry and entry fee, I hereby for myself, my heirs, executors, administrators, or anyone else who might claim on my behalf, covenant not to sue, and waive, release and discharge Wilson School District and IM Able Foundation and their affiliates, board members, agents, employees, and anyone assigned on behalf, the race committee, volunteers, and any and all sponsors including their agents, employees, assigns or anyone acting on their behalf for any or all claims of every kind of nature whatsoever, foreseen or unforeseen, known or unknown. By entering this race, I am granting permission to the Wilson School District and IM Able Foundation to use any pictures or likenesses of me secured at the event in any way they see fit without my review, restriction or compensation. Fees are nonrefundable and nontransferable. I HAVE READ AND UNDERSTAND THIS WAIVER: (if under 18, legal guardian must sign).

SIGNATURE* (PARENT OR GUARDIAN IF UNDER 18 YEARS OLD)
Note: Signatures can be completed below using a mouse and/or touch screen devices.

DATE