Building Blocks for Kids 2nd Annual 5K Run/Walk and Roll
Join with family, friends and neighbors for the 2nd Annual
Building Blocks for Kids 5k Run as well as a Walk and Roll. Men, women and
children are invited to share in the excitement as we come together in a united
effort to raise awareness and support of Building Blocks for Kids. Your
participation will help brighten a child’s future.
RUN DIVISION AWARDS: Men and
Women 14/under,15-18, 19-24, 25-29,
30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65/over
WALK DIVISION AWARDS: Men
and Women 29/under, 30-39, 40-49, 50-59,
60/over
WHAT IS BBK:
Building Blocks for Kids (BBK) is a non-profit organization that serves
families who have a child with health-related needs by providing a path to hope
and resources. We are striving to improve the well-being and quality of life
for children whose parents cannot financially meet a particular medical need
due to lack of insurance, insurance coverage, and/or family resources.
PRE-REGISTRATION: Includes T-Shirt &
Parking $ 20/Individual Kid Fun
Run/Walk/Roll: Free
Mailed-in registration must be postmarked by
Register online at www.sprunning.com
RACE DAY REGISTRATION BEGINNING AT
INFORMATION CONTACT:
Steve Prescott, Race Manager @ 513-777-1080
Ashleigh Ramsey, Race Coordinator @ BBKRace@gmail.com
Official Entry Registration Form
First Name___________________________ Last Name___________________________
Gender: M F Age ____ (on race day) T-Shirt: Size S M
L XL XXL
XXXL
Event: 5k Run 5K
Walk Fun Run/Walk/Roll
(approximately 1.4 miles)
Address:
Phone: ( )______-______ Email
(optional):_______________________
In Case of Emergency Contact:___________________________ Phone: (
)____-______
Make Checks Payable to: Building Blocks Race
Mail: BBK, c/o Steve Prescott,
Waiver
I acknowledge that participating in Building Blocks for Kids 5k
Run/Walk involves a strenuous activity, which I am physically capable of
performing, and I represent that I have received no restrictions on such
activity from any physician. I attest that I am physically fit and
have
trained sufficiently for the completion of the race. I, the undersigned,
intending to be legally bound, for myself, my heirs,
executors
and administrators, hereby waive my right to assert any claim that I may have,
now or in the future, against Building Blocks for
Kids, the City of West Chester Township, Steve Prescott, including
all event sponsors, their representatives, successors or assigns, any
agents,
volunteers, and any other individuals having any connection to the event, for
accidental injuries, property losses or hazardous health
conditions I might suffer as a result of my participation in this event. I
further grant full permission for event organizations to use my name,
likeness,
image, voice, or quotations in promotional materials presented in any medium,
This permission is perpetual and worldwide.
Signature:___________________________ Date:____/____/____
Parent or Legal Guardian (if under 18) ______________________ Date:___/____/____
Sponsors: Smith Trailers, Reece-Campbell Inc., McMobility