register - Greater Cleveland XC
TURKEY DAY 5K LAKE COUNTY CENTRAL Y 5K Run/Walk Thanksgiving Day
Thursday - November 23, 2017
Race begins 8:30 am Central Y, Painesville (Packet pickup at the Central Y, Nov. 21 3-8pm Nov. 22 8:30am – 6pm). AGE GROUPS 10 & under, 11-14 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70 & over
AWARDS Pumpkin pies to the winner of each age group and top 3 overall. Top 3 age group winners also receive awards. Prizes to best dressed runners. CEN1S14J
REGISTER
Check-in on Race Day 7:30 -8:15 am FEE $20 per person After 10/26 $25 Race Day $30 No shirt guarantee for registrations after November 13.
With Check Payable Lake County Y 933 Mentor Avenue Painesville OH 44077
First Name _________________________________________ Last Name_______________________________________________
440.352.3303
Gender M or F
Mail This Form
Go Online
www.lakecountyymca.org With Visa, MasterCard, Discover or American Express
Email __________________________________________________________________________________________________________________
DOB _______________________________________ Age (on Race Day)__________________________
Address _____________________________________________________State_____________________ZIP_____________________ Shirt Size: YS YM YL S M L XL XXL
Phone _____________________________________
Liability Release Section
I hereby accept responsibility for, and assume the risk of any injury or damage to my person or dependent children which might arise directly or indirectly as a result, and or participation in a YMCA program. I hereby expressly release, discharge and hold harmless from any liability whatsoever the City of Painesville, Lake Erie College, Lake Metroparks, the YMCA, the various branches and subdivisions thereof, and all employees and volunteers in their capacities as representatives of the YMCA, expressly including, but not limited to, the Board of the YMCA, except for injuries caused intentionally, or by willful misconduct. I certify that I am familiar with the contents of this release, that I have read and understand the same, and that it is my intention by signing this release that the same be binding not only on me, but my heirs, administrators, executors, successors, and assigns. _________________________________________________________________________________________________________________________________________________________ Signature Date _________________________________________________________________________________________________________________________________________________________ Signature Parent/Guardian if under age 18 Date rev 11/16
Thursday - November 23, 2017
Race begins 8:30 am Central Y, Painesville (Packet pickup at the Central Y, Nov. 21 3-8pm Nov. 22 8:30am – 6pm). AGE GROUPS 10 & under, 11-14 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70 & over
AWARDS Pumpkin pies to the winner of each age group and top 3 overall. Top 3 age group winners also receive awards. Prizes to best dressed runners. CEN1S14J
REGISTER
Check-in on Race Day 7:30 -8:15 am FEE $20 per person After 10/26 $25 Race Day $30 No shirt guarantee for registrations after November 13.
With Check Payable Lake County Y 933 Mentor Avenue Painesville OH 44077
First Name _________________________________________ Last Name_______________________________________________
440.352.3303
Gender M or F
Mail This Form
Go Online
www.lakecountyymca.org With Visa, MasterCard, Discover or American Express
Email __________________________________________________________________________________________________________________
DOB _______________________________________ Age (on Race Day)__________________________
Address _____________________________________________________State_____________________ZIP_____________________ Shirt Size: YS YM YL S M L XL XXL
Phone _____________________________________
Liability Release Section
I hereby accept responsibility for, and assume the risk of any injury or damage to my person or dependent children which might arise directly or indirectly as a result, and or participation in a YMCA program. I hereby expressly release, discharge and hold harmless from any liability whatsoever the City of Painesville, Lake Erie College, Lake Metroparks, the YMCA, the various branches and subdivisions thereof, and all employees and volunteers in their capacities as representatives of the YMCA, expressly including, but not limited to, the Board of the YMCA, except for injuries caused intentionally, or by willful misconduct. I certify that I am familiar with the contents of this release, that I have read and understand the same, and that it is my intention by signing this release that the same be binding not only on me, but my heirs, administrators, executors, successors, and assigns. _________________________________________________________________________________________________________________________________________________________ Signature Date _________________________________________________________________________________________________________________________________________________________ Signature Parent/Guardian if under age 18 Date rev 11/16
