Saturday =
=
&nb=
sp; =
=
&nb=
sp; September
25, 2010
=
&nb=
sp;
=
=
8:00 a.m.
=
&nb=
sp;
=
&nb=
sp; Wanda
Gray
=
&nb=
sp; =
&nb=
sp; =
Elementary Park
=
&nb=
sp;
=
&nb=
sp; (Plainview
and Cox Rd.<=
/st1:Street>)
Audrey
Pearce is a special seven month old who underwent a heart transplant in the
spring. This event will help her family with considerable medical expenses.=
This
community event will include food, drinks, inflatables=
,
the teen band “D7” , and a silent auction with
great
items from local businesses.
=
Pre-registration $20.00 =
Race Day Registration $25.00
Non-refundable
entry fee. Event is held rain or shine.
All
proceeds to benefit Audrey Pearce Medical Fund
Official
Entry Form &=
nbsp; &nbs=
p; *Race day registration<=
/span>
(Please
print) &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; opens at 7:00 a.m.
Name_____________________________________
Address___________________
City___________ *Rock
Star t-shirts!
State_____
Zip_______ Phone_______________
Register
by Sept 11 to Gender
M___ F___ Age on race day ________ guarantee
t-shirt on
Event 5K___ 1 mile_=
__email________________ race
day. Others may
T-shirt
size ___S ___M ___L ___XL ___=
XXL =
pick
up at later date.
&=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp;
=
Please
mail signed entry form and checks to: =
*Medals in each 10 yr
(Make
payable to Audrey Pearce Medical Fund) =
category in both races
Debbie
Hightower
5102 S. Elizabeth Ave. =
; &n=
bsp; =
*Trophies for overall and
Springfield, MO 65810
&=
nbsp; &nbs=
p; =
master’s finishers
Contact
info. debbie.hightower@sb=
cglobal.net
417-840-0786 &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p;
&=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp;
Waiver:
I,
the undersigned, for myself and my heirs release and hold harmless, any and=
all
sponsors and associates of this event in case of injury. I know that runnin=
g in
a road race is potentially hazardous. I further state that I am of sound mi=
nd
and body and in sufficient physical condition to participate.
=
&nb=
sp; =
&nb=
sp; =
&nb=
sp; =
______________________________________ =
&nb=
sp; =
___________________________________=
____
Signature
of athlete &nb=
sp; =
&nb=
sp; =
Signature of parent if athlete is < 18 yrs. old=
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