Running on Faith
EVUCC 2nd Annual 5K Run/Walk
Saturday, October 8, 2016
Race starts at 8am
All proceeds benefit HART of Highland
HART is devoted to supporting the lives of those facing short term obstacles in the Highland vicinity. Their mission is to be an advocate for those individuals and their families to provide them with volunteer assistance, educational resources, and financial support. www.hartofhighland.com
Location: EvUCC
2520 Poplar St
Highland, IL 62249
Registration: $20 before September 26, 2016 to receive a t-shirt
$25 after September, 2016; t-shirt not guaranteed
Payment: Cash or check payable to EvUCC
Please mail to EvUCC Attn: 5k Entry Form
2520 Poplar St, Highland, IL 62249
Packet Pick Up: 7:00am – 7:45am October 8, 2016
Timing provided by Fleet Feet; Top 3 male and female participants to receive medals
Questions: Contact Beth Hegger 618-978-5554 or
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Name: _________________________________________________________ Gender: ___________ Age: ____________
Address: __________________________________________________________________________________________
City/State/Zip: _____________________________________________________________________________________
Email address: _____________________________________________________________________________________
T-shirt Size: AS AM AL AXL AXXL No Shirt
Waiver of Liability: In consideration of your accepting this entry, I, the undersigned, intending to be legally bound, hereby, for myself, my heirs, executors and affiliates, subsidiaries, officials, representatives, employees, successors, and assigns for any and all injuries suffered by me in said event. I attest and verify that I am physically fit and sufficiently trained for the competition of this run. Further, I hereby grant full permission for the use of my name and/or any photographs, videotapes, motion pictures, recordings, and any other recording of this event for legitimate purpose.
Signature: ____________________________________________________ Date: ________________
(Parent signature if under 18)