emc website/reporter - race timing & running event services

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3 3 3 rd rd rd rd Annual EMC Annual EMC Annual EMC Annual EMC Panther Panther Panther Panther’ ’s Run s Run s Run s Run Registration Form Optional online registration available at www.pretzelcitysports.com Online registration closes at midnight on 6/1/2016 Runner’s Information: (One Runner per Registration Form) Last Name: ________________________________ First Name: ________________________________ [ ] Male [ ] Female Date of Birth: ___________________ Age: ________ Address: __________________________________ City: __________________________ State: _______ Zip: _________ Phone: ______________________ Email: _____________________________________ [ ] 5k Run [ ] 1 Mile Fun Run Register by 5/13/2016 to guarantee your T-shirt , after that it will be while supplies last. Size: (check one) [ ] Adult S [ ] Adult M [ ] Adult L [ ] Adult XL [ ] Child S [ ] Child M [ ] Child L Are you an EMC Student? [ ] Yes [ ] No Grade: __________ How did you hear about this event? [ ] EMC Website/Reporter [ ] Pretzel City Sports [ ] Facebook [ ] Other Waiver of Release & Liability : I know that running is potentially hazardous. I should not enter and run unless I am medically able and properly trained. I agree to abide by all decisions of race officials relative to my ability to safely complete the run. I assume all risks associated with running. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act in my behalf, waive and release the EMC H&S Assoc., EMC Elementary School, Souderton School District, the Boroughs of Souderton & Telford and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. NOTE: Volunteers will be on hand to guide participants, but some roads will be open to traffic. I have read & understand the above waiver. Signature: __________________________________ Date: _________________ Parent’s Signature if under 18 years of age: ___________________________ Date: __________ Registration by 5/13/2016: [ ] 5K $20 [ ] 1 Mile Fun Run $10 Registration after 5/13/2016: [ ] 5K $25 [ ] 1 Mile Fun Run $15 Race/Walk Registration Fees: ________________ Please mail completed form postmarked by 5/13/16, to: EMC Elementary School Attn: EMC Panther’s Run 143 S School Lane, Souderton PA 18964 Checks payable to “EMC Home & School Assoc.” EMC Elementary School Home & School Assoc. Presents The 3 The 3 The 3 The 3 rd rd rd rd Annual Annual Annual Annual EMC Panther EMC Panther EMC Panther EMC Panther’ ’s Run s Run s Run s Run 5k & 1 Mile Fun Run 5k & 1 Mile Fun Run 5k & 1 Mile Fun Run 5k & 1 Mile Fun Run Saturday, June 4, 2016 9:00 am EMC Elementary School 143 S. School Lane Souderton PA 18964 Rain or Shine Event Benefiting the Students of EMC Elementary School Event Schedule: 8:00am Registration / Pre-Registration Check-In 9:00am 1 Mile Fun Run Begins 9:30am 5k Run Begins Timing by Pretzel City Sports

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3333rdrdrdrd Annual EMC Annual EMC Annual EMC Annual EMC

PantherPantherPantherPanther’’’’s Runs Runs Runs Run

Registration Form

Optional online registration available at www.pretzelcitysports.com

Online registration closes at midnight on

6/1/2016

Runner’s Information: (One Runner per Registration Form)

Last Name: ________________________________

First Name: ________________________________

[ ] Male [ ] Female

Date of Birth: ___________________ Age: ________

Address: __________________________________

City: __________________________ State: _______

Zip: _________ Phone: ______________________

Email: _____________________________________

[ ] 5k Run [ ] 1 Mile Fun Run

Register by 5/13/2016 to guarantee your T-shirt , after that it will be while supplies last. Size: (check one)

[ ] Adult S [ ] Adult M [ ] Adult L [ ] Adult XL

[ ] Child S [ ] Child M [ ] Child L

Are you an EMC Student? [ ] Yes [ ] No

Grade: __________

How did you hear about this event?

[ ] EMC Website/Reporter [ ] Pretzel City Sports

[ ] Facebook [ ] Other

Waiver of Release & Liability: I know that running is potentially

hazardous. I should not enter and run unless I am medically able

and properly trained. I agree to abide by all decisions of race

officials relative to my ability to safely complete the run. I assume

all risks associated with running. Having read this waiver and

knowing these facts and in consideration of your accepting my

entry, I, for myself and anyone entitled to act in my behalf, waive

and release the EMC H&S Assoc., EMC Elementary School,

Souderton School District, the Boroughs of Souderton & Telford

and all sponsors, their representatives and successors from all

claims or liabilities of any kind arising out of my participation in

this event.

NOTE: Volunteers will be on hand to guide participants, but some roads will be open to traffic. I have read & understand the above waiver.

Signature: __________________________________

Date: _________________

Parent’s Signature if under 18 years of age:

___________________________ Date: __________

Registration by 5/13/2016: [ ] 5K $20 [ ] 1 Mile Fun Run $10 Registration after 5/13/2016: [ ] 5K $25 [ ] 1 Mile Fun Run $15 Race/Walk Registration Fees: ________________

Please mail completed form postmarked by 5/13/16, to: EMC Elementary School Attn: EMC Panther’s Run 143 S School Lane, Souderton PA 18964

Checks payable to “EMC Home & School Assoc.”

EMC Elementary School Home & School Assoc.

Presents

The 3The 3The 3The 3rdrdrdrd Annual Annual Annual Annual EMC PantherEMC PantherEMC PantherEMC Panther’’’’s Runs Runs Runs Run

5k & 1 Mile Fun Run5k & 1 Mile Fun Run5k & 1 Mile Fun Run5k & 1 Mile Fun Run

Saturday, June 4, 2016 9:00 am

EMC Elementary School 143 S. School Lane

Souderton PA 18964

Rain or Shine Event

Benefiting the Students of EMC Elementary School

Event Schedule: 8:00am Registration /

Pre-Registration Check-In 9:00am 1 Mile Fun Run Begins 9:30am 5k Run Begins

Timing by Pretzel City Sports

Please direct any race questions to [email protected]

Come run with us,

EMC Elementary School, and be a champion by helping raise money for our school!

At EMC, we encourage building

community and demonstrating

perseverance and stamina. So dig deep

and show your grit as you run the streets

of Souderton and Telford!

Medals to be given to the top male &

female overall finishers as well as the top three male & top three female finishers in

each of the following age groups:

14 & Under; 15-19; 20-29; 30-39; 40-49; 50-59; 60 & Up

Top finishers of EMC Elementary students grades K-5 will also receive medals.

EMC

Elementary

School

where

Effort

Makes

Champions