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REGISTRATION

**Please register by March 25**

Date: __________________________________________ __________________________________________ Name: _________________________________________ _________________________________________ Address:________________________________________ Address:________________________________________ City:___________ City:_____________ _______ _____ State: _____ Zip:____ Zip:___________ _________

Hawk Life Family Fun Day 5K Run/Walk & One Mile Fun Run
When: Saturday, March 29, 2014 5K Run 8AM / 5K Walk 8:05 AM / One Mile Fun Run 9AM Packet Pick Up: Friday, March 28, 2014 from 2 2-7p.m. at Stinky Feet Athletics located in Flowood at 153 Ridge Way. Where: Starting line will be in front of the Hartfield Academy East Campus located directly behind Pinelake Church at 6073 Highway 25, Brandon, MS 39047. Entry Fees: 5K Run/Walk (includes race t-shirt) $25 through February 9 $30 beginning February 10 One Mile Fun Run (does not include race t t-shirt) $15 through February 9 $18 beginning February 10

Phone: _________________ ________________________________________ _____________________________ Email: ________________________ _________________________________________ _______________________


(all race communications will be via email) Gender (Circle): (Circle): Male Female Event (Circle): 5K Run Date of Birth: _____________ _____________ Fun Run

5K Walk

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You may register online at active.com: active.com: https://endurancecui.active.com/event-reg/selecthttps://endurancecui.active.com/event race?e=6394954 Or mail registration form and fee to: Hartfield Academy Booster Club PO Box 321138 Flowood, MS 39232
*Make Make checks payable to Hartfield Academy Booster Club Questions may be emailed to hartfieldboosterclub@gmail.com

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RACE TT-SHIRTS If registering tering for 5K Run or Walk please choose t-shirt size below (one shirt included per registration): registration) Adult Shirt Size: Child Shirt Size: S XS M S L M XL L 2XL

Awards: Awards for overall and 1st, 2nd, 3rd place in each age
group/gender division will be given. Ribbons will be awarded to each child (12 and under) completing the One Mile Fun Run. Awards for One Mile Fun Run will be given to 1st, 2nd and 3rd place overall for participants 12 and under only only. If for any reason you have to leave before your award is presented you can request to have your award mailed to you after the race for $10, send an email to hartfieldboosterclub@gmail.com with your name, race distance, address, and place. 5K Run Run Divisions (male and female): female): 14 &under, 15-19, 20-29, 30-39, 40-49, 50-59, , 60+ 5K Walk Divisions (male and femal female): 10-19, 20-29, 30-39, 40-49, 50+

*T-shirt not included in Fun Run registration. T-shirt cannot be guaranteed unless registration registration is received by the organizer prior to March 14.

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ADDITIONAL RACE TT-SHIRT ORDERS $20/each (order by March 14) Adult Shirt Size: __S Child Shirt Size: __XS Total: $______ __M __ S __ _L __XL __ M __2XL __L

Release:
THE UNDERSIGNED, being a participant in the Hartfield Academy Hawk Life 5K Run/Walk and 1 Mile Fun Run, and in consideration of the acceptance of my entry and registration to participate therein, does hereby forever release and agree to hold harmless Hartfield Academy, Hartfield Academy Booster Club, Sisu Race Timing and any and all sponsors and providers of the Hawk Life Family Fun Day or any of their officers, boards, employees or agents, both individually and in their official capacities as such, from any a and nd all claims, rights, demands or causes of action of every kinds inds and character arising from any injuries or damages sustained by me in the Hawk Life 5K and/or One Mile Fun Run, , it being understood and agreed that such release from liability and hold harmless agreement shall include but not limited to any cause or causes of action related to personal injury, death, and/or hospital or medical bills or expenses of any other kind or nature which I may suffer or incur as a result of my participation in the Hawk Life 5K and and/or One Mile Fun Run. I further warrant and represent that I am in proper physical ical condition to participate in the Hawk Life 5K and/or One Mile Fun Run and am not participating in this event without consultation with my physician or against physicians advise nor am I taking medications which would impair my health or ability to participate in the Hawk Life 5K and/or /or One Mile Fun Run. WITNESS OUR SIGNATURES on this the ____ day of ___________, 20____. ____________________________________________________ SIGNATURE (Parent/Guardian if under 18) ____________________ EMERGENCY PHONE ___________________________ ___________________________________________________ WITNESS