Timed 5K Run ...... 8am

1 Mile Walk & Roll .......8:45am

at the Schott Center • Cooper City, Florida

Schott Communities is a private, non-profit organization founded in 1986 to address the needs of persons who are physically or intellectually challenged.

This unique place strives to create an environment of dignity and care in which individuals who are deaf, blind, and/or disabled are encouraged and challenged to grow in self-acceptance and independence. Over the years, its programs and services have expanded and its work in South Florida has reached increasing numbers of disabled adults, their families, and support persons.

A few examples of our programs and services include:• Adult Day Training Program• Painting and Crafting Classes• Family Support Groups• Saturday Enrichment Program• Religious Education and Sacramental Preparation

Sponsorships available.FOR INFORMATION, PLEASE CONTACT

JERRY COHEN AT 954-434-3306

Many thanks to our generous sponsors

October 19, 2019

For Persons Who AreDeaf or Disabled

5k Run, Walk and Roll

Saturday, October 19, 2019

6591 S. Flamingo RoadCooper City, FL 33330 | 954.434.3306www.SchottCommunities.org

Event Co-Chairs Andrew Almeida, Diego Zorrilla and Tim McCloskey

Proceeds benefit:

Release Form: In consideration of accepting this entry, I, the undersigned, intending to be legally bound hereby, for myself, my heirs, executors, and administrator, waive and release any and all rights and claims for losses and damages I may have against Wildside Online Inc., Split Second Timing, The City of Cooper City, The City of Southwest Ranches, Schott Memorial Center, race directors, their officers, directors, members, and volunteers, any and all sponsors including other parties and their representative successors, and assigns for any and all injuries suffered by me in said event. I attest that I am physically fit and have sufficiently trained for the competition, which I am voluntarily entering at my own risk. My physical condition has been verified by a licensed medical doctor. Further, I hereby grant full permission to any and all foregoing to use photographs, videotapes, motion pictures, recordings or any other record of this event for any purpose whatsoever. Use of strollers or baby joggers and headsets or Walkmans/Ipods, are not permitted on the course during the Timed 5K Run.

No one may enter this event without signing this official waiver.

__________________________________________________ Signature Date

If under 18, signature of legal guardian is also required.

__________________________________________________ Signature Date

For Persons Who AreDeaf or Disabled

___________________________________________________________________Last Name First Name

___________________________________________________________________Male / Female Age Birthday M/D/YR

___________________________________________________________________Mailing Address City State Zip

___________________________________________________________________Telephone E-Mail Address

If you would like to receive text, Facebook and/or Twitter messaging, please sign up at

www.splitsecondtiming.com.

Evento 5K Timed Run o 1 Mile Walk & Roll

Feeso Early Registration $25 o Race Day Registration $30

Paymento Cash o Check o Visa o MC o AMEX

___________________________________________________________________Credit Card Number Security Code Exp. Date

___________________________________________________________________Signature

Please make checks payable to: Schott Communities 6591 S. Flamingo Road, Cooper City , FL 33330

Shirt Sizeo Y o S o M o L o XL

Date: Saturday, October 19, 2019Place: Schott Center 6591 S. Flamingo Road, Cooper City, FL 33330Times:Race Day Registration ................6am

5K Timed Run .................................................8am

1 Mile Walk & Roll .................................8:45am

(Walk is non-competitive. No chips or awards)

Entry Fees:Early Registration $25 Race Day Registration $30(Fee non-refundable, includes breakfast for all participants and T-Shirts to first 600 participants)

Pre-Registration in person or by mail:Schott Communities6591 S. Flamingo Road, Cooper City, FL 33330954-434-3306Mon. - Thurs. 9am – 5pm • Friday 9am – NoonOther Participating Locations:Runner’s Depot2233 S. University Drive, Davie, FL | 954-474-4074

Register On-Line:www.splitsecondtiming.com www.schottcommunities.org

Registration closes at noon on Friday, October 18, 2019 at all locations. Participants can register at the race site beginning at 6am on Saturday, October 19, 2019.

Packet Pick-Up at Schott CommunitiesOctober 16 & 17 .......................................9am – 5pm

October 18 ...........................................................9am – NoonOctober 19 ...........................................................Starting at 6am

Anyone registering online on October 16, 17 and 18 cannot pick up their packet until the morning of the event (October 19).

The Schott Run, Walk & Roll6591 S. Flamingo Road | Cooper City

October 19, 2019

Please print clearly in ink to ensure application is processed correctly.

APPLICATION FORM

Bib#

Official use only

Running Wild2563 East Sunrise BlvdFt. Lauderdale, FL | 954-565-9400

For Persons Who AreDeaf or Disabled

Booth Rentals: A limited number of booths will be available to reserve at a cost of $100 which includes a 10’ x 10’ pop-up tent, one table and two folding chairs. To reserve a booth, contact Jerry Cohen at 954-434-3306 or jcohen@schottcommunities.org.

School Teams for The Schott Run, Walk & Roll: Get a team together! Ask family, friends and neighbors to donate on your team’s behalf. You can have lots of fun while helping a worthy cause. Prizes for the top fundraisers will be awarded. Win a pizza party for the school with the top team! It’s another way to raise funds for the Schott Communities. For more information, call Jerry Cohen at 954-434-3306

Age Divisions: 8 & Under, 9-10, 11-12, 13-14, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70-74, 75 & over

Awards 5K Run:Top 3 Overall Male/FemaleTop 3 Masters Male/FemaleTop 3 Male/Female (in each Age Division)

Breakfast: Scrambled eggs, sausage, potatoes, and much more sponsored by the St. Maximilian Knights of Columbus. Compli-mentary for all participants. Guests are welcome to purchase breakfast tickets for $5.00 each.

Timing: The 5K Run event will be timed with the Chronotrack Timing System. Race results and photos available at www.splitsecondtiming.com.

Heat Warning: Temperatures/humidity can be high in South Florida. Participants should drink plenty of fluids (non-alcoholic) for 48 hours prior to, during and upon finishing the race. Beware of heat-injury symptoms (dizziness, no sweating, nausea, cramps, redness, incoherent speech and thoughts). Seek immediate assistance if symptoms occur. Wear loose, light-colored clothing.