MILES for MEALS

MILES for MEALS

1st ANNUAL 5K Run/Walk

Sponsored by (WCCSS)

Western Clinton County

Senior Services

All proceeds go to provide meals to residents residing in the communities of Trenton,

Albers, Damiansville, Aviston, New Baden, and New Memphis, IL

Location/Courses: Start and finish for both events will be held at New Baden Park, 1103 E Hanover St., New Baden, IL (Located 30 minutes east of St. Louis off Interstate 64)

Shirts: Event T-shirts provided for pre-registered entrants. Race day and late registrations are not guaranteed a T-shirt

Awards: Awards will be given to the top 3 Male/Female finishers overall for the following age groups: 70 & over, 60–69, 55-59, 50-54, 45-49, 40-44, 35-39, 30-34, 25-29, 20-24, 15-19, 11-14, and 10 and under.

Registration: Postmarked by 10/11/13: $25. Postmarked after 10/11/13 Race Day entry fee: $30

Race Day Registration: 7:45 a.m. – 8:45a.m. NOTE: Event may be canceled due to threatening weather. Entry fees are non-refundable.

Packet Pick-Up: 7:45 a.m. - 8:45 a.m. on race day

For Information: Registration forms can be downloaded from www.wccss.org. For race information, call WCCSS 224-9913 or email or WCCSS [

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MILES for MEALS ~ 5K RUN/WALK

Make checks payable and mail this form to: WCCSS, 520 North Main St.,Trenton, IL 62293

ONE ENTRANT PER REGISTRATION FORM

Name: Phone (evenings):

Address: City/State/Zip:

Age (on Race Day): Gender: Male Female E-Mail Address:

Circle T-Shirt Size: Youth-M Youth-L Adult-S Adult-M Adult-L Adult-XL Adult-XXL

Circle Event: 5K Run 5K Walk

Friend donation (receives shirt) $25 $30 $35 $50 $75 $100 Other______

Please Enter Fee Enclosed: $______

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 administrators, waive and release any and all claims for damages, actions and causes of actions against the Village of New Baden, New Baden Park, New Baden Chamber of Commerce, their 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 have 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, or any other record of this event for legitimate purpose.

SIGNATURE: ______

Signature (Parent Signature if under 18) DATE