7/29/2019 2013 HoH Run-Walk Entrance Form

1/1

The 2nd Annual HHCEF Healthy on the Hudson 5k Race/Walk & Health Expo

Saturday, April 20, 2013

1 mile Kids Fun Run 9 am StartOn the High School Track

5K Race/Walk 9:30 am StartFeaturing Beautiful Hudson River Views

Event timing provided by ARE Event ProductionsFor Parent Racers/Walkers - Supervised Kids Fitness Clinic at 9:30 (12 and under)

Health Expo 9 am - 12 pmAdult & Youth Fitness Classes,Healthy Food & Product Demos & Sales, Health Lifestyle Info

Tennis at the Lake St tennis courts Special Needs Adaptive Tennis Clinic and Adult Round Robin with the High School Varsity Team

REGISTER online at HHCEF.ORG or mail this form with your check to: HHCEF, PO Box 114, Montrose, NY 10548Make checks payable to: HHCEF

Pre-Registration for 5K Race/Walk or Tennis Race Day Registration for 5K Race/Walk or Tennis$25 Adults (19 and over) $30 Adults (19 and over)

$15 Students (18 and under) and Seniors $20 Students (18 and under) and SeniorsSchool Teams - $100 (advance only, up to 15 participants) $5 Kids Fun RunFirst 200 registrants receive a t-shirt

Race Day Regisistration and Check in:Time and Location: 8:00 to 8:45 AM in the Gym at the Hendrick Hudson High School Campus

2166 Albany Post Road (Rt. 9A)

Name __________________________________________________________________________

Address_______________________________City________________State____Zip_______

Phone ____________________E-mail______________________________________

Age on Race Day________ GENDER (M/F) ___

Check One: Run_____ Walk_______ Tennis_______ 5k Team Name(if applicable)__________________________________

WAIVER: I know that running a race is a potentially hazardous activity. I should not enter and run/walk unless I am medically able and properly trained. Iagree to abide by the decision of a race official relative to my ability to safely complete the run. I assume all risks associated with running/walking thisevent including but not limited to falls, contact with other participants, the effect of the environment, including weather, traffic and conditions of thecourse, all such risks being known and appreciated by me. Having read this waiver and knowing these effects and in consideration of my entry, I, formyself and anyone entitled to act on my behalf, waive and release HHCEF, The Town of Cortlandt, The Village of Buchanan, the Hendrick HudsonSchool District, ARE Event Productions, and all sponsors, their representatives and successors from all claims of liability of any kind arising out of myparticipation in this event, even though that liability may arise out of negligence or carelessness on the part of the persons named in this waive. I grantpermission to all of the foregoing to use photographs, recording or any other record of this event for any legitimate purpose. I understand bicycles,skateboards, roller skates/blades, animals are not allowed in this race/walk and I will abide by these guidelines.

Signature of participant*________________________________________________Date_____________

*Parent or guardian signature is required if the participant is under 18 years of age