Sign Up Form

Tupperware Brands Corporation

5K Run/Walk and 1 Mile Fun Run

Name:
________________________________________

Saturday, April 16, 2016

8:30 AM

Age:
______________________________
Date of Birth:
____________________________________
Contact Information
Address:______________________________
_____________________________________
Phone Number:
_____________________________________
Please Circle One
Male

or

Female

5K

or

1 Mile Fun Run

T-Shirt Size
Sm

Med

Large

X-Large

By signing below, I attest that I have read the risk

and liability waiver on this flyer and agree to all
the terms. Parents must sign for children under
18.
_______________________________________
Date: ____________________________

Tupperware Brands Corporation

P.O. Box 1000
Hemingway, SC 29554
Phone: 843-558-4372
Fax: 843-558-4770
E-mail: edmondbaxley@tupperware.com

Help us support the Rick & Susan Goings

Boys and Girls Club in our community!

Tupper 5K RUN/WALK
& 1 Mile Fun Run
April 16, 2016
Please help Tupperware support the Rick &
Susan Goings Boys and Girls Club by
participating in our 5K or 1 Mile Fun Run
Our mission is to enable all young people,
especially those who need us most, to
reach their full potential as productive,
caring and responsible citizens. The need
for your support is beyond question.

Packets:
Each participant will receive a bag containing a T-shirt &
some goodies. Water and snacks will be provided on the
day of the event. Bags will be available for pick-up from
7:00 AM8:30 AM on the day of the event.

Prizes: 5K
1st Place male and female winners will receive a
trophy and a $50.00 gift certificate to Dicks
Sporting Goods.

WAIVER: I know that running/walking a road race is

a potentially hazardous activity. I should not
enter unless I am medically able and properly
trained. I assume all risks associated with
participating in this event. Having read this waiver
and knowing these facts and in consideration of your
accepting my entry fee, I, for myself, and anyone
entitled to act on my behalf, waive and release
Tupperware Brands Corporation and all sponsors,
their representatives and successors, from all
claims or liabilities of any kind arising out of my
participation in this event.

Medals will be given to all top finishers in each of

the mens and womens age groups.

Help us provide our community with a safe

place for our youth to learn and grow.

Prizes: 1 Mile Fun Run

Please join us in our mission!

Course Description:

To Be Awarded
Race will start at 8:30 AM at the Hemingway
Elementary School. The race will proceed down
Baxley Road to Lewis Road. Right on Lewis Road to
Hwy 41/51. Right on 41/51 to Hwy. 261. Right on
Hwy 261 to Baxley Road. Right on Baxley Road and
end at Hemingway Elementary School.
Sign Up:

Pre-Race Day Registration Fee:

$20.00
Race Day Registration Fee: $25.00
Children under 17 Fee: $15.00
(Fee only applicable if children want
to be timed and eligible for awards
and T-Shirts)

You may sign up online at

www.simplytiming.com or you may fill out this
flyer and mail it in to the address listed on this
brochure.

Mail Checks and Entry Forms to:

Tupperware Brands Corporation
Edmond Baxley
P.O. Box 1000
Hemingway, SC 29554