Jingle Bell Jog 5K Entry Form

Manistee Jingle Bell Jog

5K Run / Walk

Saturday, Dec. 5^th, 2009 10am

Fundraiser for the Manistee Area Public Schools / Catholic Central

Cross Country Teams

Where: Manistee Middle School, 55O Maple St. Manistee MI

Entry Fees: $15 Before Nov. 30^th, $20 on race day

Entry includes specially-designed long sleeve T-shirt (sizes guaranteed until Nov. 30^th only)

Packet Pick-up / Late Registration: 8:45-9:45 am at Manistee Middle School.

Race will begin promptly at 10am, with awards immediately following

Course: 3.1 Miles (5K) through the streets and picturesque neighborhoods of historic Manistee – during the Old Victorian Christmas Weekend Celebration

Awards: Plaques to the top overall runners and walkers. Specially designed medals to the top 3 finishers in each age category for the run. Medals to the top 5 overall male and female walkers.

Age Categories: Run – male and female: - 10-under, 11-13, 14-16, 17-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70+up. Walk – male and female division only.

For more info – call Coach Thuemmel: (231) 398-9374 or e-mail ethuemmel@manistee.org

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Send Entry form with check payable to:

“Manistee Cross-Country” c/o Manistee Area Public Schools, 525 12^th St., Manistee, MI, 49660

Name:________________________ Gender M / F Age (on Dec. 5^th) ______

Address: __________________ City: ___________ State: ____Zip:______

Phone Number:____________________ E-Mail ____________________

Event: 5K Run 5K Walk T-shirt Size: YL S M L XL

$15 per entrant ($20 after Nov. 30^th) Total enclosed ________

Please accept my entry to the Jingle Bell Jog 5K run / walk. I hereby state that I have conditioned myself to run / walk more than the stated distance for the race in which I am entering. I understand that the roads may be snow-covered and slippery during the race, and traffic will continue. I waive any rights I have against any sponsor or agents for damages and injuries incurred by my participation in the Jingle Bell Jog 5K run / walk.

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Signature (parent’s signature if entrant is under 18 years old) Date

(this form may be duplicated)