Benbrook `15 letter

27th Annual Lake Benbrook 1/2 Marathon & 5K
5K
$20 thru December 14, 2014
$25 thru January 18, 2015
$30 thru January 24, 2015
Half Marathon
$40 thru December 14, 2014
$50 thru January 18, 2015
$60 thru January 24, 2015
5K group price minimum of 5 @ $20
per runner thru January 18, 2015
1/2 Marathon group price minimum of 5 @ $40 thru January 18,
What:
2015 (5K & 1/2 group pricing entries
Lake Benbrook Half Marathon/5K
must be mailed together) Long
When:
Saturday January 24, 2015 8:30 a.m. sleeve shirts guaranteed to all preregistered participants.
Where:
Lake Benbrook, Dutch Branch Park Packet pick-up:
Polansky Race Management
at Winscott Rd. and Hwy. 377S,
3619 Byers Avenue
Benbrook, TX
Fort Worth, TX 76107
Registration by mail:
January 22-23 9:00 am to 6:30 pm
Lake Benbrook 1/2 Marathon & 5K
Awards: Half Marathon and 5K
3619 Byers Avenue
Male/Female Overall, Masters OverFort Worth, TX 76107
all and Grand Masters Overall plus
Registration online:
normal 5 year age groupings
www.active.com
Additional Info: 817-228-6261 or info@lakebenbrookhalfmarathon5k.com
Last Name:
Address:
City:
Email:
Sex: M F
Make checks payable to: Lake Benbrook Half Marathon Entry copies acceptable - make one for a friend
Please Print
First Name:
State:
DOB:
Event (Circle One) Half 5K T-Shirt Size: (Circle One) S M L XL XXL Group Name:
Waiver Statement - Entry Invalid If Not Signed. Fees are non-refundable
Zip:
In consideration of the acceptance of this registration entry, I, the undersigned, assume full and complete responsibility for an injury or accident which may occur during the participation in this race, or while I am on the
premises of this event and I hereby release and hold harmless RunTIME Racing Services, Polansky Race Management, the sponsors, promoters and all other persons and entities associated with the event or their agents or
employees, or otherwise. Further, the City of Benbrook isn’t a sponsor of this event and is harmless from any claims, suits causes of action and liability arising out of the use and occupancy of all City of Benbrook park areas and
Entrant’s Signature
Signature of parent/guardian if under 18 years old