Saturday, November 3, 2012, 8:30 am

Run through beautiful University Heights & Jamestown-Lincoln Neighborhoods Packet pick up/registration Friday, Nov. 2, 5-7 pm, by the Thames track; Race day registration begins 7:30 a.m. Awards: 5K awards to 1st, 2nd, 3rd male & female in each age group; overall male & female; masters and grandmasters; walk awards to top 3 overall 5K age groups: <11; 12-19; 20-29; 30-39; 40-49; 50-59; 60-69; 70< Fees: Non-refundable. Early: $20 for walk/run (by Oct. 19); Late: $25 for walk/run; Early family rate: $60 (for families over 3 peoplemust register together) Information:Email: atkins.sayre@gmail.com Phone: 601-467-2339 Facebook: https://www.facebook.com/events/320023981424912/ Web site: http://sites.google.com/site/thames5krace/
Pre-register by October 19, 2012, mailing/hand-delivering the form to Thames Elementary, 2900 Jamestown Road, Hattiesburg, MS, 39402. Make checks payable to Thames Elementary PTA.

---------------------------------------------------------------------------------------------------------------------------Registrant Name: __________________________________ Phone: __________________________ Address: ____________________________ City: __________________ State: ____ Zip: __________ Email: _____________________________________________________________________
Name Age on race day Male/Female 5K or 2 Mile?

T-shirt size
(YS/M/L; AS/M/L/XXL/XXL)

I agree my participating in this event is without assumption of any kind of responsibility by THAMES ELEMENTARY or Hattiesburg Public Schools, officials and assistants. I release all of the above from any claim for any injury I may sustain or suffer in connection with this road race. I further give permission for the use of my name and or photograph in post race publicity. I attest that I am physically fit and sufficiently trained for the completion of this event.

Signature ___________________________________________________
(Parent or Guardian must sign for runner under 18 years old)