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Revere Runs 5K An event to celebrate the City-Wide Fitness Challenge

June 8, 2013
9:00 AM to 12:00 PM

Revere Runs 5K

An event to celebrate the City-Wide Fitness Challenge

Saturday, June 8, 2013 9:00 AM

WHAT: Professionally timed 5k run/walk in West Revere.

WHERE: Race starts at the West Revere School Complex, 107 Newhall Street, Revere, MA

ENTRY FEE: Pre-Registration -$15.00 A portion of registration fees will be donated to The One Fund to help those affected by the tragic events on April 15, 2013. Race day registration - $20.00 (cash only) from 7:30-8:30 AM. Registration closes at 8:30AM!

PRIZES: Prizes for top male and female winners as well as top male and female runners in each age division

T-SHIRTS: The first 300 runners and walkers who register will receive a T-shirt

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Revere Runs 5K Entry Form Make checks payable to: City of Revere

Register online at http://www.NorthShoreTimingOnline.com/reglivecb.aspx?eventyear_id=93 or mail to:

Revere Recreation Center

150 Beach Street Revere, MA 02151

Email: acosta02151@comcast.net or Julie_demauro@hotmail.com

NAME__________________________________________________________

ADDRESS:______________________________________________________

PHONE:_______________________________ T-Shirt Size ____S ____M ____ L____ XL____

EMERGENCY CONTACT NAME___________________________EMERGENCY CONTACT PHONE:______________________

WALK_______ RUN________ GENDER_____________ AGE ON RACE DAY___________

I know that running a road race is a potentially hazardous activity and that I should not enter and run/walk unless I am medically able and properly trained. I agree to abide by any decisions of a race official relative to my ability to safely complete the run/walk. I assume all risks associated with running in this event including, but not limited to falls, contact with other participants, and effects of the weather including heat and/or humidity, lightning, and extreme cold, traffic and the conditions of the road such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I for myself and anyone entitled to act on my behalf, waive and release the City of Revere and all sponsors and event volunteers, their representatives and successors from all claims of liabilities of any kind arising out of my participation in this event or carelessness on the part of the persons named in this waiver. Further, I grant permission to all the foregoing to use my name and images of myself in any photographs, motion pictures, results, publications or any other print, video graphic, or electronic record of this event for legitimate purposes.

__________________________________________________ _____________________________________________

Signature If under 18, parent or guardian

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