5K/10K Run to the Wall ENTRY FORM

ONE participant per form!

Honor our HEROES by

personalizing your race shirt. Details on next page.

AWARDS
5K/10K: Top three overall military male & female, top three overall (nonmilitary) male & female and top three male & female in the following age groups: 14 & under, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, and 70 & over. 5K walk: Top three overall male & female. In order to qualify you MUST walk over the finish line.

Date: Saturday, August 4, 2012 Race starts promptly at 7:30 am Registration: 67:15 am Proceeds benefit the Ohio Veterans Memorial Park
Entry fees: (postmarked) By March 31, 2012$18 for 5K Run/Walk,

$20 for 10K By July 25, 2012$20 for 5K/Run/Walk, $25 for 10K July 26, 2012 thru race day$25 for 5K Run/ Walk, $30 for 10K
The race will be at the OVMP 8005 Cleveland Massillon Rd. Clinton, OH 44216 The race will begin at the memorial park. Runners will exit the drive, run N to S Van Buren and loop back. 10K runners will run to Center Rd, then to S Van Buren and loop back.

5K USATF Certified OH11008MW / 10K pending

For online registration, go to:

I would like to make a tax-deductable donation

Signature Date

www.rsracingsystems.com

in the amount of:___$________________________

(please consult your tax advisorOVMP is an IRS 501(c)(3) non-profit organization, ID # 20-3904984)

Pre-registration is encouraged NO REFUNDS

Signature of guardian if under 18 years

Date

This entry is for: 5K Run

Army Navy

5K Walk

10K Run Marines N/A

Please include ALL information Name requested. In order to receive a Address t-shirt, entries must be received by EOB July 27, 2012.

The entrant is on active duty or a veteran of:

Air Force Coast Guard National Guard

Release: In consideration of the acceptance of this entry to the

You may mail this form and entry fee to:

Race Director 140 West Wilbeth Road Akron, OH 44301

Phone: 330-773-2385 Web address: www.ovmp.org FAX: 330-773-2820
(checks payable to OVMP)

Phone

E-mail address

T-shirt Size: S Gender

XL

XXL

Date of birth (required)

PLEASE PRINT CLEARLY!

OVMP 5K/10K Run/Walk to the Wall, I do hereby, for myself or my children, my heirs, executors and administrators, waive and release and discharge the OVMP 5K/10K Race, and any hosts or sponsors, or their respective agents, representatives and employees, from all claim, demands and right of causes of action, present and future, whether known or anticipated, resulting from or arising out of, either directly or indirectly, my participation or my childs participation in the OVMP 5K/10K Run/Walk to the Wall. I attest that I am physically fit and sufficiently trained for completion of this race. I hereby grant full permission to any or all the foregoing to use any photographs, videotapes, motion pictures, recordings or any other record of the event for any legitimate purpose. I have been informed that entrants under 18 years of age require parental approval and signature on this form in order to participate in this event. I have read and understand the foregoing assumption of risk and affix my signature and the

date hereto.

Do you want to help provide a priceless memorial for the families of the Ohioans that lost a loved one in Beirut Desert Storm, Operation Iraqi Freedom, Operation New Dawn or Operation Enduring Freedom? Select a HERO from www.ovmpconcert.com and enclose an extra $10 with you race fee to have the back your t-shirt personalized with their name. Proceeds raised will allow us to have the names engraved on the Wall located at the Park. You may also purchase an additional t-shirt for $20 with the same name or the name of another HERO.
I have enclosed a $10 donation to have the following name printed on the back of my race t-shirt. Personalized tshirts are only guaranteed if registered by July 13, 2012. Name of Hero as you want it to appear on your shirt:

Honor our Heroes

I would like to order an additional t-shirt(s) and have enclosed $20 for each additional t-shirt. Additional personalized t-shirts must be received by July 13, 2012 and can be picked up after the race on Saturday, August 4, 2012. Name of person ordering tshirt (if different that registered runner): Phone number: Name of Hero as you want it to appear on your shirt: T-shirt size: S M L XL XXL Email:

Name of Hero as you want it to appear on your shirt: T-shirt size: S M L XL XXL

Name of Hero as you want it to appear on your shirt: T-shirt size: S M L XL XXL

**Mail both registration and order form to: Race Director, 140 W Wilbeth Rd, Akron, OH 44301**