2015 Registration Form

Sunday, August 9, 2015
Location:
Start at Fort Haven (former FJ Elementary School)
145 4th St., Fort Jennings, Ohio 45844
End at St. Joseph’s Parish
135 N. Water St., Fort Jennings, Ohio 45844
Race Times:
1 Mile Fun Run at 8:00
5k Run/Walk at 8:30
Course Map: 5k: http://www.mapmyrun.com/routes/view/716519817
1 mile: http://www.mapmyrun.com/routes/view/716503379
Entry Fees:
All Proceeds to Benefit the
Musketeer Athletic Boosters
Before July 1st – 5k Run/Walk = $20 (Fort Jennings Students = $15); 1 Mile Fun Run $10
After July 1st – 5k Run/Walk = $25 (Fort Jennings Students = $20); 1 Mile Fun Run $15
All registration fees include performance shirt, shirt not guaranteed if received after July 13, 2015.
Shirt only = $20; All unclaimed shirts will be resold.
On-Line Registration: FJStacheDash.eventsbot.com
Race Day Info: Registration time – 7:30 to 8:15 AM in Fort Haven North Parking Lot
Awards Ceremony – Following the 5k at St. Joseph’s Parish Homecoming
Strollers welcome, please NO pets
5k Overall Top 3 for Each Gender
1st - $100, 2nd - $50, 3rd - $25
5k Top 2 per age group for each gender (medals)
• 14 and under
• 15-19
• 20-29
• 30-39
• 40-49
• 50+
All 1 mile fun run participants will receive a medal
For Any Questions, please email: FJMAB@hotmail.com
Awards:
Make checks payable to:
Musketeer Athletic Boosters
Return entry form and payment to:
Musketeer Athletic Boosters
PO Box 32
Fort Jennings, Ohio 45844
Cut Along Line and return lower portion with payment
Name:
Age on August 9, 2015
Email Address:
Circle Gender: Male
Circle Event:
Female
Circle Shirt Size:
S
M
5k
YS
YM
YL
L
XL
2XL (+$2)
1 Mile
Shirt Only
3XL (+$3)
4XL (+$4)
Total Amount Enclosed:
I have read/understand the waiver below (Signature of parent if under 18):
Signature:
Date:
Waiver & Release: I have read the accompanying event information and understand the policies of the event. I know that running and walking a race is a potentially
hazardous activity. I should not enter unless I am medically able and properly trained. I assume all risks associated with my voluntary participation in this event, and
WAIVE, RELEASE AND DISCHARGE Musketeer Athletic Boosters, et. all for ANY AND ALL claims or liability, whether foreseen or unforeseen, for arising out of, or in the
course of my participation in this event. I further grant full permission to use any photographs, videotapes, or other record of the event for any reasonable purpose.