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When: Saturday, January 25, 2014 - 5K Run/Walk and a One Mile Kids Fun Run to follow (12 & Under) at 8 a.m. Packet Pick Up: Friday, January 24, 2014, will be at the Rankin County School District Oce located at 1220 Apple Park Place, Brandon from 3-6 p.m. Where: Starting line is at the Rankin Landing parking lot located oSpillway Road at the Ross Barnett Reservoir. Registration Information Date: ___________________________ Name: ___________________________ Address: ___________________________ City: ________________ State: _____ Zip: ___________ Phone:  ________________________ Email: _________________________________________ Gender (Circle): Male Female Age on Race Day: ___________ Event (Circle): 5K Walk 5K Run Fun Run Adult Shirt Size (Circle): S M L XL XXL Child Shirt Size (Circle): XS S M L T-shirts can not be guaranteed if not pre-registered. 5K Run 5K Walk 1 Mile Fun Run Over all male and female winners, masters male and female, grand masters male and female, and top three in each age group will be awarded prizes. 19 and under, 20-29, 30-3 9, 40-49, 50-59, 60-69, 70 & over. Over all male and female winners, masters male and female, grand masters male and female, and top three in each age group will be awarded prizes. 19 and under, 20-29, 30-3 9, 40-49, 50-59, 60-69, 70 & over. T op three male and female finishers will receive awards age group 0-12 Register online at: http://www.raceit.com/search/event. aspx?id=23478 Mail form and entry fee to: Foundation for Rankin County Public Schools, Inc. Attention: Robin Haney P.O. Box 1359 Brandon, MS 39043 Phone: 601-825-5590 E-mail: robin.haney@r csd.ms ACKNOWLEDGMENT AND RELEASE  THE UNDERSIGNED, being a participant in the Hot Chocolate Classic 5K Run/Walk and 1 Mile Fun Run, and in consideration of the acceptance of my entry and registration to participate therin, does hereby forever release and agree to hold harmless. The Foundation for Rankin County Public Schools, Inc., the Ran kin County, Mississippi School District. Mississippi Race Timers, LLC and any and all sponsors and  providers of the Hot Chocolate Classic or any of their ofcers, boards, employees or agents, both individually and in their ofcial capacities as such, from any and all claims, rights, demands or causes of action of every kinds and character arising from any injuries or damages sustained by me in the Hot Chocolate Classic, it being understood and agreed that such release from liability and hold harmless agreement shall include but not limited to any cause or causes of action related to personal injury, death, and/or hospital or medical bills or expenses of any other kind or nature which I may suffer or incur as a result of my participation in the Hot Chocolate Classic.  I further warrant and represent that I am in proper physical condition to participate in the Hot Chocolate Classic and am not  participating in this event without consultation wit h my physician or against physician’s advise nor am I taking medications which would i mpair my health or ability to participate in the Hot Chocolate Classic.  WITNESS OUR SIGNATURES on this the ____ day of ___________, 20____.  ________________________________ ____________________ ____________________________ SIGNA TURE (Parent/Guardian if under 18) EMERGENCY PHONE WITNESS Entry Fee $20 Adults pre-registered by Thursday, January 9 $25 Adults after Thursday, January 9 and Race Day $15 Children pre-registered by Thursday, January 9 $20 Children after Thursday, January 9 and Race Day  Awards Ceremony

Hot Choc Jan25

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Page 1: Hot Choc Jan25

 

When: Saturday, January 25, 2014 - 5K

Run/Walk and a One Mile Kids Fun Run

to follow (12 & Under) at 8 a.m.

Packet Pick Up: Friday, January 24,

2014, will be at the Rankin County School

District Office located at 1220 Apple Park

Place, Brandon from 3-6 p.m.

Where: Starting line is at the Rankin

Landing parking lot located off Spillway

Road at the Ross Barnett Reservoir.

Registration Information

Date: __________________________________________

Name: _________________________________________

Address: _______________________________________

City: ________________ State: _____ Zip: ___________

Phone: _________________________________________

Email: _________________________________________

Gender (Circle): Male Female

Age on Race Day: ___________

Event (Circle): 5K Walk 5K Run Fun Run

Adult Shirt Size (Circle): S M L XL XXL

Child Shirt Size (Circle): XS S M L

T-shirts can not be guaranteed

if not pre-registered.

5K Run

5K Walk

1 Mile Fun Run

Overall male and female winners,

masters male and female, grand

masters male and female, and top three

in each age group will be awarded

prizes. 19 and under, 20-29, 30-39,

40-49, 50-59, 60-69, 70 & over.

Overall male and female winners,

masters male and female, grand

masters male and female, and top three

in each age group will be awarded

prizes. 19 and under, 20-29, 30-39,

40-49, 50-59, 60-69, 70 & over.

Top three male and female finishers will

receive awards age group 0-12

Register online at:http://www.raceit.com/search/event.

aspx?id=23478

Mail form and entry fee to:Foundation for Rankin County

Public Schools, Inc.

Attention: Robin Haney

P.O. Box 1359

Brandon, MS 39043

Phone: 601-825-5590

E-mail: [email protected]

ACKNOWLEDGMENT AND RELEASE

  THE UNDERSIGNED, being a participant in the Hot Chocolate Classic 5K Run/Walk and 1 Mile Fun Run, and in consideration

of the acceptance of my entry and registration to participate therin, does hereby forever release and agree to hold harmless. The Foundation for

Rankin County Public Schools, Inc., the Rankin County, Mississippi School District. Mississippi Race Timers, LLC and any and all sponsors and

 providers of the Hot Chocolate Classic or any of their ofcers, boards, employees or agents, both individually and in their ofcial capacities as

such, from any and all claims, rights, demands or causes of action of every kinds and character arising from any injuries or damages sustained by

me in the Hot Chocolate Classic, it being understood and agreed that such release from liability and hold harmless agreement shall include but not

limited to any cause or causes of action related to personal injury, death, and/or hospital or medical bills or expenses of any other kind or nature

which I may suffer or incur as a result of my participation in the Hot Chocolate Classic.

  I further warrant and represent that I am in proper physical condition to participate in the Hot Chocolate Classic and am not

 participating in this event without consultation with my physician or against physician’s advise nor am I taking medications which would impair

my health or ability to participate in the Hot Chocolate Classic.

 

WITNESS OUR SIGNATURES on this the ____ day of ___________, 20____.

 ________________________________ ____________________ ____________________________ 

SIGNATURE (Parent/Guardian if under 18) EMERGENCY PHONE WITNESS

Entry Fee

$20 Adults pre-registered by

Thursday, January 9

$25 Adults after Thursday, January 9

and Race Day

$15 Children pre-registered by

Thursday, January 9

$20 Children after Thursday, January 9

and Race Day

 Awards Ceremony

Page 2: Hot Choc Jan25