Annual 5K

October 21th, 2017 9:00 AM

Sudden Cardiac Arrest Research and Education

Registration Form

Location: Ocmulgee National Monument
1207 Emery Highway
Macon, GA 31217
Entry Fees: $15 Early Registration
$20 After Oct. 10th
$25 Day of Race (7:30am-8:15am)
5K begins at 9:00am
Race Packet Pickup:
Oct. 19th and 20st at Georgia Arrhythmia Consultants between 9am-4pm
639 Hemlock St. Macon, GA upstairs
(478) 755-1560
Or race day on site 7:30am / All race entrants receive a Technical fabric T-shirt
5K: Cash Prizes
$150 First Place Overall Male and Female
$100 Second Place Overall Male and Female
$ 75 Third Place Overall Male and Female
$ 50 Master(40+)/Grand Master(50+)/Great Grand Master(60+)Overall First Male and Female
Awards: Age group awards 3 deep as follows: 10&under, 5 yr ages groups thru 75+. No duplication of awards.

Georgia Arrhythmia Foundation, a nonprofit organization, hosts event to increase community awareness of SCA and support the need for AED placement in schools and other public places as well as community education regarding BLS training. AEDs will be awarded at event.

Make checks payable to Georgia Arrhythmia Foundation. Mail Form to GAC c/o Kathy Frazier

639 Hemlock St. Ste 100, Macon, GA 31201. Questions regarding the race can be directed to Kathy Frazier @ (478) 755-1560 or email to

Register on line at: gacri.com

Name______Sex: M F Date of Birth______Age______

Address______City/State/Zip: ______

Telephone :(___) ______E Mail______T-shirt size S M L XL XXL

Waiver: In consideration of acceptance of this entry, I waive any and all claims for myself and my heirs against the officials, sponsors, or any person or persons in conjunction with the SCARE event.

I understand running a race can be hazardous. I am in proper physical condition to participate in this event.

Signature: ______Date:______

How did you hear of this event (circle) Friend / Work / Social Media / Flyer

Public photos will be taken and possibly used for marketing. Opt out ______