POUNDING FOR PAWS

FUNDRAISER FOR SUMTER HUMANE SOCIETY SATURDAY, MAY 10, 2014 ENTRY FEE: $20 FOR 1 MILE/$30 FOR 5K YOU AND A FRIEND: $30 FOR 1 MILE/$40 FOR 5K T-SHIRTS TO ALL PARTCIPATES WHO PRE-REGISTER BY APRIL 25TH CHECK IN: 7:30-8:00 A.M. AT REESE PARK START TIME 8:15 FOR 1 MILE-5K TO FOLLOW

Participants Name: _______________________________________________________ Circle one: 1 mile T-Shirt size(circle one) Youth: Small Medium Large Adult: Small Medium Large XL 5K

Awards will be given to top overall male/female in 5K and top overall male/female in 1 mile For questions, please contact Ruth Olsen at 229-924-0268 or Chrissy Ambos at 229-944-0299. In consideration of acceptance of this entry, I waive any and all claims for myself and my heirs against officials or sponsors of the run for injury or illness which may directly or indirectly result for participation. I further state I am in proper physical condition to participate in this event.

________________________________________________________ Date ________________________ Signature (Parent or Guardian if under 18)

Please return this form along with your fee to:

Sumter Humane Society

108 Industrial Blvd. Americus, GA 31719 229-924-0268