Mail-in Registration

Participant Registration Form
Please join us for the Inaugural CES 5K & Fun
Run! The race will be digital timed. Awards will
be given for overall male and female, and age
group Awards! Feel free to wear your Purple
Hurricane Spirit Wear we want people to take
notice of the Cause we are walking/running for.
All proceeds of this year’s 5K & Fun Run will go to
Cartersville Elementary School.
Saturday, March 21, 2015
Cartersville Elementary School
340 Old Mill Rd. , Cartersville, GA
7:00 am Registration
8:00 am 5K Begins
9:00 am Fun Run Begins
Awards & Raffle Prizes Following the Fun Run
On-line Registration: www.aaaraceservices.com
Make Checks Payable & Mail to: CES 340 Old Mill Rd. Cartersville, GA 30120 TELEPHONE NUMBER MUST BE ON CHECK
Name:_________________________________________ Gender M F
Date of Birth:_____________
Address:____________________________________________________________ Age on Race Day:________
Email Address:____________________________________________ Phone:__________________________
Registration forms received by March 4th will receive an event T-shirt. After March 4th, registrants will receive
T-shirts on a first come, first serve basis (availability is limited).
Pre-registration:
Fun Run: $15
5K:$25 Phantom Runner: $20(T-Shirt Only)
After March 4th:
Fun Run: $20
5K:$30 Phantom Runner: $20(T-Shirt Only)
Youth Shirt Size: S M L XL
Adult Shirt Size: S M L XL 2XL
WAIVER: I understand that participating in the event can potentially be a hazardous activity presenting risk. I, and anyone entitled to act on
my behalf, waive and release from all claims and liabilities of any kind arising out of my participation. I agree to hold harmless Cartersville
Elementary School, Cartersville, GA, all sponsors, volunteers, and all other parties, connected with this event from any liability as a result of
my participation. I will permit emergency treatment in the event of injury or illness while participating, and give permission to use my name
and photo taken of me during the event in any promotional material, publication or website. I certify that I have read and understand the
intent of this waiver and release.
Signature (If under 18, Must be signed by Parent or Guardian)
Date
Contact: Monica Ward Gober Email: monicawardgober@gmail.com Phone: (678)719-2087
https://runsignup.com/Race/GA/Cartersville/CartersvilleElementarySchool5KandFunRun