SHIRT DESIGN

COPY AND PASTE FORM(S) TO PRINT OUT

Coach E 5K Registration

Saturday, October 1, 2016

Schedule of Events

7:00-7:45 AM            Registration in gym at Brunswick School (1008 County Road)

8:00 AM                      Bus leaves school for start line

8:15 AM                       Race Starts

 

Entry Fees & Registration Deadlines

$25.00 (includes t-shirt)

Sweatshirts & Hoodies Also Available (registration must be received by September 16th)

T-shirts cannot be guaranteed on race day if pre-registration is not received.

Parking

Participants must park in the north parking lot of Brunswick School (follow signs)

 

Course

Starts on west side of Grand River Bridge west of Brunswick, goes through downtown Brunswick and finishes at the Brunswick School. Course is primarily flat and paved.

 

Awards

1st Place Overall Male & Female

1st Place Male & Female each age group (12 & under, 13-18, 19-30, 31-40, 41-50, 51-64, 65 & over)

Registration & Information                           More Information

Registrations may be mailed to:                                  Call: (660) 676-2093

Kimberly Jacobs                                                          E-mail: coacheraces@gmail.com

16547 Ohio Road                                                        Facebook:  Coach E. Races

Brunswick MO 65236                                      Website:  www.coacherace.org

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Checks payable to: CCCF–Chariton County Community Foundation

 

Name:_______________________________________________   Number of years participating:_

Address:__________________________________ City:__________________________ State:_______ Zip:________

Phone:_____________________________________ E:mail:_________________________________________________

Birthdate:_______ Gender:_______ Emergency Contact: _________________________ Phone: ______________

Shirt Size: T-Shirt (included) __________  Sweatshirt (Add $20) __________  Hoodie (Add $20) __________

I know that participating in this walk/run is potentially hazardous. I should not enter unless I am medically able and properly trained.  I also assume any and all risks associated with this event including but not limited to falls, contact with other participants, the condition of the roads and traffic, and the effects of the weather (including high heat and/or humidity).  All such risks being known and appreciated by me.

Knowing these facts, and in consideration of your accepting my entry, I hereby, for myself, my heirs, executors, administrators, or anyone else who might claim on my behalf, covenant not to sue, and waive, release and discharge Coach E 5K Race Directors, the Edmundson Family, the Pecan Festival Committee, the City of Brunswick, and/or any agents authorized by them for any purpose.

This release and waiver extends to all claims of every kind or nature, whatsoever, foreseen or unforeseen, known or unknown. It also authorizes the use of my photos and/or likeness for any promotional materials regarding the Coach E Races and may be posted to the race website and/or Facebook page.  Such likeness will not be sold to other parties.  Applications for minors are only accepted with a parent/guardian signature.

Signature of Participant:_____________________________________________ Date:____________________

Signature of Parent/Guardian:_______________________________________ Date:____________________

(Only required if participant is under 18)

 

Coach E 10K Registration

Saturday, October 1, 2016

Schedule of Events

7:00-7:45 AM            Registration in gym at Brunswick School (1008 County Road)

8:15 AM                       Race Starts

 

Entry Fees & Registration Deadlines

Must be 18 years of age to participate.

$35.00 (includes t-shirt)

Sweatshirts & Hoodies Also Available (registration must be received by September 16th)

T-shirts cannot be guaranteed on race day if pre-registration is not received.

 

Parking

Participants must park in the north parking lot of Brunswick School (follow signs)

 

Course

Starts at Brunswick School, run left (south) onto Highway Y, run left (south) onto Highway 24, run to Highway M turnoff (at the bottom of King Hill), cross highway and come back to school.

 

Awards

1st Place Overall Male & Female

1st Place Male & Female each age group (18-30, 31-40, 41-50, 51-64, 65 & over)

 

Registration & Information                           More Information

Registrations may be mailed to:                                  Call: (660) 676-2093

Kimberly Jacobs                                                          E-mail: coacheraces@gmail.com

16547 Ohio Road                                                        Facebook:  Coach E. Races

Brunswick MO 65236                                      Website:  www.coacherace.org

------------------------------------------------------------------------------------------------------------------------------

Checks payable to: CCCF–Chariton County Community Foundation

 

Name:_______________________________________________   Number of years participating:_

Address:__________________________________ City:__________________________ State:_______ Zip:________

Phone:_____________________________________ E:mail:_________________________________________________

Birthdate:_______ Gender:_______ Emergency Contact: _________________________ Phone: ______________

Shirt Size: T-Shirt (included) __________  Sweatshirt (Add $20) __________  Hoodie (Add $20) __________

I know that participating in this walk/run is potentially hazardous. I should not enter unless I am medically able and properly trained.  I also assume any and all risks associated with this event including but not limited to falls, contact with other participants, the condition of the roads and traffic, and the effects of the weather (including high heat and/or humidity).  All such risks being known and appreciated by me.

Knowing these facts, and in consideration of your accepting my entry, I hereby, for myself, my heirs, executors, administrators, or anyone else who might claim on my behalf, covenant not to sue, and waive, release and discharge Coach E 10K Race Directors, the Edmundson Family, the Pecan Festival Committee, the City of Brunswick, and/or any agents authorized by them for any purpose.

This release and waiver extends to all claims of every kind or nature, whatsoever, foreseen or unforeseen, known or unknown. It also authorizes the use of my photos and/or likeness for any promotional materials regarding the Coach E Races and may be posted to the race website and/or Facebook page.  Such likeness will not be sold to other parties.  Applications for minors are only accepted with a parent/guardian signature.

 

Signature of Participant:_____________________________________________ Date:____________________