Turlock Chaplaincy

Presents

5k Run &
Relay Race
Saturday, April 9th, 2011, 9:00am
Crane Park, Berkeley Ave., Turlock, CA
The 5k and Relay course is a flat loop through a residential district.
Entry Fee: 5k - $15, Relay - $25 per team if mailed before April 1, 2011
After April 1st, 5k - $20, Relay - $30
Every finisher receives a medal!
Awards: 5K - Medals three deep in ten year age groups through 60 +
Plaques to overall Male and Female finisher
3 Person - Relay Divisions: Corporate/Business - Service Club (Youth & Adult)
School (Elementary & High School) – Churches (Youth & Adult)
Police /Fire

For Information: Call Kellie Marshall @ 634-8017 or kelliemarshall@charter.net

Turlock Chaplaincy 5k Run & Relay

Name 5k  $15 Relay  $25

Relay Division: (Each member/walks/crawls /runs 1 mile)

Relay Members1) 2) 3)

Address Age on Race Day

City State Zip Male / Female (Circle)

Phone E-mail Address

I have enclosed my check in the amount of $ made out to: Turlock Chaplaincy

Please mail registration form and non-refundable payment to: Turlock Chaplaincy
C/O Kellie Marshall, 3940 Story Road, Denair, CA 95316
Liability Waiver: (the following must be signed to enter the race) By signing this form, I acknowledge that the information I provided
is accurate to the best of my knowledge. In consideration of your accepting entry, I, Intending to be legally bound, do hereby for
myself, my heirs, executors, and administrators waive and release forever any and all rights and claims or damages I may accrue
against the Turlock Chaplaincy race management, event, their representatives, successors and assigns for any and all injuries
suffered by me in connection with this event including pre- and post-race activities. I also grant Turlock Chaplaincy the right to use
any images of me taken at the race.

I have read my rights: Signed: Date:

(If you are under 18 years old, your parent or legal guardian must sign this form)