8:30 a.m.

ßullonvood Iark
W. Aflon & S. Main Sl.
YardIey, IA
The YardIey 5K is successfuI because of
lhe many voIunleers invoIved. VoIunleer
o¡¡orlunilies invoIve selling u¡ lhe
course, regislralion, valer slalions and
more. If you are inleresled in voIunleering,
¡Iease emaiI YardIey ßoro al:
Lncatinn: ßullonvood Iark, W. Aflon &
S. Main Slreel, YardIey, IA. The race viII
slarl and finish on Wesl Aflon Avenue,
|usl oulside ßullonvood Iark.
Entry Fcc:
$20.00 thrnugh Junc 2, 2012
$25.00 Junc 3, 2012 - racc day
Regislralion acce¡led al ßorough HaII unliI
}une 7, 2012. You may aIso regisler onIine al
aclive.com unliI }une 8, 2011 al:


Race Day regislralion viII be heId from
7:00a.m. lo 8:00a.m. al ßullonvood Iark.

Iee incIudes a ¡rinled T-shirl lo lhe firsl 200
regislranls. Size cannol be guaranleed.
S¡onsored by YardIey ßusiness Associalion
S¡onsored by YardIey ßusiness Associalion
Race Course.

$tartin¸ point will be on Atton Avenue, just
outside Buttonwood Park. Participants will
tollow Atton Avenue to River Road. North on
River Road to Woodside Road to Delaware
Canal. $outh on Delaware Canal to Brown
$treet to River Road to Atton Avenue.

|nirq jcc nusi |c su|niiic! uiin
rcgisiraiicn jcrn.

$20.00 cnirq jcc nusi |c !rcppc! cjj ai Yar!|cq
Bcrcugn Ha|| cr pcsinarkc! |q junc 2, 2012.
|cgisiraiicns ajicr inai !aic arc $25.00

Make aII checks ¡ayabIe lo
YardIey ßorough Recrealion ßoard

Mai! nr in Pcrsnn Prc-Rcgistratinn
YardIey ßorough Recrealion ßoard
YardIey ßorough HaII
56 Soulh Main Slreel
YardIey, IA 19067
Prc-Rcgistratinn unti! Junc 7, 2012

Racc Day Rcgistratinn
ßullonvood Iark
Cash or Check 7:00-800a.m.

On!inc Rcgistratinn

The firsl 200 regislranls viII receive a T-shirl

T-shirls can be ¡icked u¡ al lhe designaled area
al ßullonvood Iark lhe day of lhe race.

Ior More Informalion
I-maiI: p|nhnsnnmyard!cybnrn.cnm
Yard!cy 5k Fun Run/Wa!k

A scparatc Inrm must bc cnmp!ctcd
Inr cach individua!

Iarlici¡anl Name: ____________________________
Sex: (CircIe one) MaIe IemaIe
Address: ____________________________________
Cily: ________________ Slale: _____ Zi¡: _______
Ihone: (______)______________________________
ImaiI: ______________________________________
Dale of ßirlh: __________ Age on Race Day: ____
TolaI Iaid: __________________________________

Assumptinn nI Liabi!ity: I undersland lhal lhis
¡rogram carries lhe ¡ossibiIily of ¡hysicaI in|ury and
may invoIve ¡hysicaI aclivily lhal may be slrenuous and
lhal lhere are risks inherenl in lhis recrealionaI aclivily. I
furlher undersland lhal YardIey ßorough and ils officers
and agenls are nol IiabIe for any in|uries lhal may resuIl
from lhe negIigence of ¡ersons conducling lhis recrea-
lionaI ¡rogram. I aIso give my ¡ermission for lhe use of
my name and/or ¡iclure in any nevs¡a¡er, broadcasl or
olher accounl of lhis evenl.

5ignaturc nI Each Participant nr Parcnt/Guardian nI
cach minnr Participant Rcquircd.

Signalure: ____________________________________

Dale: ________________________________________

5cnd Tn:
YardIey ßorough Recrealion ßoard
YardIey ßorough HaII
56 Soulh Main Slreel
YardIey, IA 19067
ImaiI: ¡|ohnson+yardIeyboro.com

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