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5 k Registration Form

5 k Registration Form

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Published by tricountyrecord
The registration form for the Keeping the Beat 5K.
The registration form for the Keeping the Beat 5K.

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Published by: tricountyrecord on Mar 13, 2013
Copyright:Attribution Non-commercial


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Twin Valley Music 5K

Saturday, April 20th: 8:00am Registration l 9:00am 5K Start Time l Kids’ Fun Run After 5K Course: Start/Finish at TVHS Cross Country Course, 4897 Twin Valley Road, Elverson, PA 19520 Proceeds from this race will benefit Twin Valley Music Boosters. Twin Valley Music Boosters is a non-profit organization whose main mission is to support and connect the school district’s music programs.  $20 entry fee must be postmarked by April 3rd, 2013. ($25 after April 3rd, including race day.)  T-shirts for all entrants registered by April 3rd, all others while supplies last, including race day.  Professionally timed by Pretzel City Sports, results posted on website following race  Start and finish at Twin Valley High School Track, cross country course  Registration begins at 8:00a.m., 5K at 9:00a.m., fun run at 9:45a.m.  Rain or shine event, no refunds under any circumstances  Awards presentation following the race  Age Groups: 60+, 50-59, 40-49, 30-39, 20-29, 15-19, 10-14, 9 & under  Winners must be present to receive awards.

Visit us on Facebook: www.facebook.com/TwinValleyKeepingTheBeat5K

Race Application
Name: ________________________________________________________ DOB: ____________________ M / F

Address: __________________________________________________________________________________ Phone:____________________________________ Email: _________________________________________ Emergency Contact Name and Number: _________________________________________________________ T-shirt Size: S M L XL XXL Youth S Youth M

Participating in: (select one) 5K ($20 before April 3rd / $25 after) ____, Fun Run ($2) ______, Fun Run w/shirt ($12) _______ Mail Application to Jennifer Tennant, 3 Center Ave, Morgantown, PA, 19543. Checks payable to Twin Valley Music Boosters Optional Online Registration at www.pretzelcitysports.com (closes at midnight, Wed Apr 17, nominal service fee applies)


I acknowledge that running or walking in a 5K race and/or fun run can be a potentially hazardous activity. I hereby for myself, heirs, executors, administrators or anyone else who might claim on my behalf, covenant not to sue and waive, release and discharge the Twin Valley Music Boosters, Twin Valley School District, Pretzel City Sports and any sponsors or volunteers. This waiver extends to all claims of every kind or nature whatsoever, unforeseen, or unknown. I claim responsibility for taking part in this event. Signature: ____________________________________________________ (under 18 requires signature of parent or guardian) Date: _____________________

Make a donation or get more information from our Race Director, Jennifer Tennant, at jbtennant88@gmail.com or 610-850-5240.

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