Jackson R2 School District
Run/walk for wellness: 5k or 1 mile
Saturday April 28, 2012
8 a.m.- Jackson Jr. High School
Cost: Adults $20.00/children (age 6-18) $10.00/ Free under age 6
race day registration: $25/$15
Pick up DRY FIT t-shirts at Orchard on Friday April 27th or day of race.
Registration (deadline April 20th)/money can be sent to Joyce McIntosh at Orchard Elementary.
Make checks payable to Jackson R2 School District
Age divisions: 6-12, 13-16, 17-19, 20-29, 30-39, 40-49, 50-59, 60 and over
Metals for top three in each category.
Name: ______________________________________Age on race day:____
Address:_________________________________Phone#______________
email:___________________________________ Sex: M or F (circle one)
Check event: Run 5k____ Walk 5k____Run 1 mile _____ Walk 1 mile _____
T-shirt Adult: X- Large, Large, Medium, small Youth: small, medium, large, extra large
Release: I know that running is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I assume all risks associated with this event, including, but not limited to falls, contact with other participants, the effects of weather, traffic and road conditions of the course, all such risks being known and appreciated by me. Having read this waiver and knowing the facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the Jackson R2 School District and the city of Jackson, their representatives and successors from all claims or liabilities of any kind arising from participation in this event.
Signature (parent if under 18 years old) Date
Contact information: Joyce McIntosh 1402 Orchard Dr. Jackson, MO. 63755 243-9571