ChiLLyChiLi Run

5k run - 2 mi. walk - Kids Fun Run

December 13, 2014

Linden, Alabama

Registration: Register by Mail or In person at Linden City Hall

Race Day Registration (located in the Linden Fire Department)

Starting Times: Run/Walk: 9:00AM Fun Run: 9:30 AM

Awards:Overall Winners-Male & Female

Age Division-Male (1st, 2nd,3rd) 13-19, 20-29, 30-39, 40-49, 50-59,60+

Age Division-Female (1st,2nd,3rd) 13-19, 20-29, 30-39, 40-49, 50-59,60+

Kids Fun Run- All participants will receive a participation ribbon

Entry Fees:Race/Walk:$15 by November 26, 2013; after$20 Fun Run: $10 by November 26, 2013; after $15

Entry includes a ChiLLyChiLi Run Shirt

(Pre-registered runners are guaranteed shirts; day of race registrants will receive shirts while supplies last)

If you have any questions call Terry Tyson at 422-1408.

2014 Entry Form

Please complete a separate form for each participant.

Name______Address______

City______State______Zip______DayPhone______Email______

Age on Race Day ______Birth Date ______Sex______Event: _____5K Run _____2 Mile Walk _____Fun Run

Shirt Size: (circle one) Adult S M L XLXXLYouth S M L

______Age/Division Race Number (to be assigned day of race) ______

Total Enclosed: $______

In consideration for the acceptance of my registration as a participant in the above entitled event, and with the understandingthat my participation in this event is only on condition that I enter into this agreement, for myself, my heirs and assigns, I hereby assume the inherent and extraordinary risks inherent in any other activities connected with this event in which I mayvoluntarily participate. I expressly assume the risk of and accept full responsibility for any and all injuries (including death)and accidents which may occur as a result of my participation in this event and release the City ofLinden and each of theiragents, representatives and employees. I hereby waive any claim I may hereafter have as a result of my participation in this

Event and any other activities connected with this event in which I may voluntarily participate. I hereby agree to indemnify allof the above named persons for any and all claims including attorney’s fees and costs, which may be brought against any ofthem by anyone claiming to have been injured as a result of any injury to me or my property which may occur as a result ofthe event. I certify that I have read and fully understand this release. I am of lawful age and legally competent to make this agreement.

Signatureof Participant______Date______

(Parent/Guardian must sign for participants under 19)

Make checks payable to: City of Linden / ChiLLy Run

Mail completed applications and fees to: ChiLLy ChiLi Run

211 North Main

Linden, AL 36748