2012 SWEET TATER TROT
5K ROAD RACE-1 MILE RUN AND WALK
SATURDAY, OCTOBER 27, 2012
– ALL PROCEEDS GO TO
OCILLA WOMEN’S LEAGUE
START/FINISH: FARM BUREAUREGISTRATION BEGINS AT 7:15 AM AT THE
FARM BUREAU OFFICE
THE ONE- MILE STARTS AT 8:00AM THE 5K STARTS AT 8:30 AM
DIRECTIONS: Turn left onto Hwy 90 East off of Highway 129 South in Ocilla. Go approximately ¾mile. Turn right into Farm Bureau Office.
Pre-registration Deadline: October 13, 2012
5K and 1 Mile Pre-registration Fee $20 for 13 and older $15 for 12 and younger Groups of 10 or more Pre-registration discount is $15 per participant (must pay for entire group together)SAME DAY REGISTRATION FEE $25
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2012 SWEET TATER TROT ENTRY FORM
ENTRY FEE: 5K & 1 MILEPre-registered (by Oct. 13th) $20
$15 (see above)Late Registration (after Oct. 13th) $25Make Checks Payable to
& Mail To:Sherry Werner 1139 Frank RoadOcilla, GA 31774Last Name First Name MIAddress (Number & Street, P. O. Box) City State Zip Code ____________Male _____________Female _________Age Phone#____________________ Race Entry: __________5K (3.1 miles) ________ 1 Mile Run & Walk Adult T-Shirt Size: ________X-Large __________Large ________Medium ________Small
SAME DAY REGISTRATION DOES NOT GUARANTEE TSHIRT
INCOMPLETE OR UNSIGNED ENTRY FORMS WILL NOT BE ACCEPTED.
In consideration of my entry being accepted, I intend to be legally bound and do hereby, for myself, my heirs and executors, waive allrights and claims for damages which I may have or which may hereafter accrue to me against the sponsors or any subsidiary or politicalsubdivision thereof, its or their respective officers, agents, representatives, successors, assigns and sponsors for any and all damages or injuries which may be sustained and suffered by me in connection with, association with or entry or participation in the Tater Trot. If Ishould suffer injury or illness, I authorize the officials of the race to use their discretion to have me transported to a medical facility and Itake full responsibility for this action. I attest and verify that I am physically fit and have sufficiently trained for the completion of thisevent
I HAVE READ THE ABOVE RELEASE AND UNDERSTAND THAT I AM ENTERING THISEVENT AT MY OWN RISK.