Speedy-Feet.com - Race Registration

Race Entry:

Race Name:

3rd Annual
Feet for Food 5k

Race DateTime:

6/1/2013 9:00 AM

Race Location:

Fairborn United Methodist Church
100 N Broad St
Fairborn, OH 45324

Race Description:

Why do this event? The Feet for Food 5K Run / Walk supports our SnakPak Ministry which feeds children in Fairborn Primary Schools. We pack over 140 of these packs a week with 8 to 10 non-perishable food items per pack for children that don’t have an opportunity to eat over the weekends.

Participant #1:

First Name:	Participant Email:
Last Name:	Participant Phone:	--
Address:	Gender:
City:	Birthdate:	(ex: MM/DD/YYYY)
State:	Emergency Contact Name:
Zip:	Emergency Contact Phone:	--
Payment Option:	T-Shirt Size:
Coupon Code:
Age as of June 1, 2013:	:		:	:	:	:

Race Waiver:

In consideration of your accepting this entry, I, the undersigned, intending to be legally bound hereby, for myself, my heirs, my executors and administrators, voluntarily assume all risks of injury to my person and damage to my property; agree to abide by all ordinances of the City of Fairborn, Ohio and all rules, regulations, and directions, if any, of this event; wave and release any and all fights and claims for damages I may have against Fairborn United Methodist Church, Speedy Feet, their representatives, employees, officials, volunteers, successors, and assigns for any and all injuries and damages to me or my property in said event; and agree to indemnify defend and hold those same organizations and individuals harmless from any claims for injury or damage to myself and to third persons or their property from this event. I attest and verify that I am physically fit and have sufficiently trained for the completion of this event, and my physical condition has been verified by a licensed medical doctor. I hereby authorize Fairborn United Methodist Church and its assigns and any news media, radio, movie or TV producer, having permission from or acting for the benefit of Fairborn United Methodist Church to show and reproduce my name, photograph, pictures, and films taken of me by any of these mentioned above.

I have read the Race Waiver and agree to the terms and conditions

Participant #1:

Participant #2:

Participant #3:

Participant #4:

Participant #5: