Lamar County Spring Festival 5K
Saturday, April 30, 2005

Little Black Creek Water Park

Time :

5K Run begins at 8:00 a.m.

Awards:

Ø Unique, custom awards in each age group: 0-19, 20-29. 30-39. 40-49. 50-59, 60+

Ø Top 3 Male and Top 3 Female runners in each age group will receive trophies

Ø 5K Run trophies will also be presented to the Overall, Master & Grand Master finishers in both males and female categories. 

Entry Fees:

  Ø Pre-registration postmarked by April 15th, 2005

$15.00 all event categories

$12.00 Pine Belt Pacers Club Members & under 18

Ø Day of Race registration:

$20.00 all event categories

Ø $50.00 Families over 3 people

Tee Shirts:

Tee-shirts are only guaranteed on race day to those registered before April 15th, 2005.

Mail Entries to:

Tara Ladner
P.O. Box 1240
Purvis, MS 394754
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Lamar County Spring Festival 5K

Registration

Name: _____________________________ Age on Race Day:_____ DOB:___/___/___

Address: ___________________________ Phone: (home) _______________________

City / State / Zip: _____________________________ (day time) _____________________

E-Mail Address: ________________________________________________________________

Sex (circle one) Male Female Tee-shirt size (circle one) S M L XL

Waiver for the Lamar County Spring Festival 5K Run

In consideration of the acceptance of this entry, I assume full and complete responsibility for any injury or accident which may occur while I am
traveling to or from the event, during the event, or while I am on the premises of the event. I am also aware of and assume all risks associated with
participating in this event, including but not limited to falls, contact with other participants, effect of weather, traffic, and conditions of the road. I,
for myself and heirs and executors, hereby waive, release and forever discharge the event organizers, sponsors, promoters, and each of their agents,
representatives, successors and assigns, and all other persons associated with the event, for all my liabilities, claims, actions, or damages that I may
have against them arising out of or in any way connected with my participation in this event. I understand that this waiver includes any claims,
whether caused by negligence, the action on inaction of any of the above parties, or otherwise.

I understand that the entry fee is non-refundable and non-transferable. I hereby grant full permission to any and all of the above parties to use any photographs, videotapes, motion pictures, web site images, recordings or any other record of this event.

Signature: __________________________ Date: ____/______/______

(Parent if under 18 years of age)