Play Hard Sports Duathlon & 5K

January 30, 2010 ~ Pinckney Colony Road

February 27, 2010 ~ Rose Dhu Creek Plantation

EVENTS

5K Run or Duathlon (5K Run, 6 Mile Off Road Bike, 5K Run)

2 and 3 person duathlon teams are welcome

Both races will start at 8:30am.

PACKET PICK-UP & RACE DAY REGISTRATION

Race morning from 7:30am - 8:15am.

Packets cannot be mailed.

Race day registration is an additional $5

T-SHIRTS

Shirts are only guaranteed to the first 100 runners (one shirt for both dates).

RUN DIVISIONS

Male & Female; 8 & under, 9-12, 13-19, 20-29, 30-39, 40-49, 50-59,

60-64, 65 & over

AWARDS

Awards presented to Top 3 overall males and Top 3 overall females

as well as the first place finisher in each age division.

No Duplications. Awards will also be given to the top three teams.

R E G I S T R A T I O N F O R M

Please make checks payable and mail to: Play Hard Sports Inc. 17 Lady Cobra Ln

Okatie, South Carolina 29909

For directions and online registration visit playhardinbtown.com or call (843)816-2979

Name: ______Age: _____Gender:______

Address: ______City: ______State:___

Phone: ( ) ______E-mail: ______

Shirt Size: ___YM ___S ___M ___L ___XL ___XXL ($3 additional charge on XXL)

Check one event: ___5K ___Duathlon ___Duathlon Team

Team Name:____________

Check the date(s) you will be participating: _____January 30 _____February 27

Registration Fee: Adults (individuals and teams) $25 per race

Students (18 & under) $15 per race

The cost for adults is only $45 if registering for both dates.

Total Amount Enclosed ______(Sorry NO Refunds)

In consideration of your accepting my/my child’s registration, I hereby for myself, my child, my heirs, executors and administrators waive and release any and all rights and claims for damages I or my child may have against Play Hard Sports, Inc., Play Hard Event Timing, LLC, and all representatives who are in any way connected with this event/program. Further, in the event of any injury, I do hereby give permission and consent to authorize such First Aid and/or Medical and/or Hospital care or treatment as deemed appropriate. In addition, I am fully aware of the provisions covered by the fee for this event and I understand that if any emergency arises, any and all additional expenses incurred must be borne or assumed by the participants. I do hereby give Play Hard Sports, Inc. permission to take photographs of my child or myself while participating in this event. I understand that these photographs may be used for the promotion of future events, advertising and public relations including, but not limited to brochures, flyers or newspapers.

Signature:______Date:______

(Parent or Guardian must sign if under 18)