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    Dare Run Registration Forms

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    Herkimer Dare
    The summary is: The 16th Annual DARE 5k Run and Junior Fun Run will take place on August 20, 2011 in Herkimer, NY. The Jr. Fun Run will begin at 8:30am and the 5k run will begin at 9:15am, both starting and ending in front of the Historic Herkimer County Jail. Awards will be given to the top male and female runners in several age categories. A post-race party will include refreshments, a DJ, and raffles.

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    Dare Run Registration Forms

    Uploaded by

    Herkimer Dare
    172 views1 page
    The summary is: The 16th Annual DARE 5k Run and Junior Fun Run will take place on August 20, 2011 in Herkimer, NY. The Jr. Fun Run will begin at 8:30am and the 5k run will begin at 9:15am, both starting and ending in front of the Historic Herkimer County Jail. Awards will be given to the top male and female runners in several age categories. A post-race party will include refreshments, a DJ, and raffles.

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    The summary is: The 16th Annual DARE 5k Run and Junior Fun Run will take place on August 20, 2011 in Herkimer, NY. The Jr. Fun Run will begin at 8:30am and the 5k run will begin at 9:15am, both starting and ending in front of the Historic Herkimer County Jail. Awards will be given to the top male and female runners in several age categories. A post-race party will include refreshments, a DJ, and raffles.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    172 views1 page

    Dare Run Registration Forms

    Uploaded by

    Herkimer Dare
    The summary is: The 16th Annual DARE 5k Run and Junior Fun Run will take place on August 20, 2011 in Herkimer, NY. The Jr. Fun Run will begin at 8:30am and the 5k run will begin at 9:15am, both starting and ending in front of the Historic Herkimer County Jail. Awards will be given to the top male and female runners in several age categories. A post-race party will include refreshments, a DJ, and raffles.

    Copyright:

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    Download as DOC, PDF, TXT or read online from Scribd
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    THE DATE HAS CHANGED The 16th Annual DARE 5k Run The 1st Jr.

    Fun Run
    Saturday, August 20, 2011 @ 9:15am
    (Visit us on-line) Herkimer DARE on Facebook.com

    Course: Both runs will begin and end in front of the Historic Herkimer County Jail. The Jr. Fun Run will commence at 8:30am. The 5k run will commence at 9:15am. The Entry fee: Pre-registration Adult run $20.00, Jr. Run $10.00, any registration not received by August 15th, Adult $25.00, Jr. Fun Run $15.00 T-shirts: Free T-shirts will be given to the first 100 paid registered adult runners. T-shirt handout, registration numbers begin at 7:30 am the day of the race. Award Ceremony/Post Race Party: After all runners finish, Refreshments & DJ following the race, there will also be a bicycle raffle and a 50/50 raffle. The awards are as follows: Awards to the top three males and females in these categories: 12-15 and 16-19. Awards will also be given to the top male and female in these categories: first male and first female overall, 20-29, 30-39, 40-49, 50-59, 60-69 and 70 and over. All Jr. Participants will receive a t-shirt. Top Jr. High and Sr. High teams will receive individual metals. Team Competition: Minimum 5 runners per team/winners determined by total accumulated time of first 5 finishers. Pledges: These runs are fundraisers for the DARE program, therefore any runner wishing to help raise money may do so by obtaining sponsor pledges or donations in memory of Anthony Enea. Any runner collecting pledges totaling $100 or more will have their entry fee waived, and receive a DARE awareness bracelet. Information: Pltm. Steven D. Elwood at 315-866-4330 (7am-7pm), e-mail at dareherkimer.@yahoo.com or Herkimer Dare at facebook.com. You can also register and pay on-line at our facebook page. On-line payment will only be accepted through paypal, dareherkimer@yahoo.com. Donations are also graciously accepted by check or paypal. Official Entry Form-DARE 5k and Jr. Fun run August 20, 2011 Name:__________________________________ Age:______ Sex: M F Shirt Size: S M L XL (circle one) Street Address:___________________________________________E-mail:_________________________________ Phone Number: ________________________ Circle the run in which you wish to participate: (fun run) (5k) All Jr. run participates must be 12 and younger. Participants for the fun run can have an adult accompany them at no cost. Team Name:____________________________________ Team Category: (Jr. High) (Sr. High) (Baileys) (Police)
    Waiver: I know that running a road race is a potentially hazardous activity. I should not enter unless I am medically able and properly trained. I agree to abide by any decision of race officials relative to my ability to safely complete the run. I assume all risks associated with running in this event including, but not limited to: falls, contact with other participants, the effects of weather, including high heat and or humidity, traffic and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I for myself and anyone entitled to act on my behalf, waive and release the Herkimer Police Department, the village of Herkimer, race organizers and volunteers, all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver.

    Signature:__________________________________________ Date:__________________________ Parents Signature if under 18:___________________________________________ Donation Pledge Total: $________________ Pay on-line via PayPal: dareherkimer@yahoo.com Make checks payable to: Herkimer Police Department DARE program Mail Payment and registration form to: DARE program, Herkimer Police Department, 120 Green St., Herkimer, NY 13350

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