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The
Center for Women |
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Phone: 828-885-7885 Fax: 828-885-7829 E-mail: cpccare@citcom.net Website: www.brevardwomenscenter.com |
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START TIME: |
9:00 AM
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ENTRY FEE: |
Early Bird fee of $25 prior to November 29 and $20 for children 5-12. No participants younger than 5. $30 for adults after Nov. 29th and on race day. ($25 for children ). |
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REGISTRATION: |
Race-day registration will be held from 7:15 to 8:45 AM in the fellowship hall of the First Baptist Church in downtown Brevard (free parking at the church). |
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SHIRTS: |
Free t-shirts for all pre-registered. Guaranteed to get your size if registered by Nov. 20th. |
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REFRESHMENTS: |
Post-race food will include fruit, granola bars, muffins, donuts, water, coffee and juice. |
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COURSE: This is a |
This is a USA Track and Field Certified Race Course! |
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AWARDS: |
Cash awards given for the top two male and female overall finishers. Awards for all children 12 and under. Metals will be given to the top 3 male and female finishers in each of the following categories: 5-12, 13-18, 19-29, 30-39, 40-49, 50-54, 55-59, 60-64, 65-69, 70-75, 76-79,80 and over. |
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PRE-REGISTRATION: Register
online at www.active.com
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ENTRY FORM: Print out and mail this entry form along with your check made payable to: THE CENTER FOR WOMEN at 39 E Jordan St. Brevard, NC 28712. All mail entries must be received by November 29th. All fax, e-mail, and online entries must be received by Dec. 1st and paid for with your Visa or Master Card.
Please e-mail or
fax your credit card entries to the following: E-mail: cpccare@citcom.net Fax: 828-885-7829. For more information call: 828-885-7885
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Visa |
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MasterCard |
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Card Number: |
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Expiration Date:
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Name on Card: |
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3 or 4 digit CVV2 code on back of card: |
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T-SHIRT SIZE |
ADULT |
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M |
L |
XL |
XXL |
YOUTH
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Medium |
Large |
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Name: |
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Age: |
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MALE |
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FEMALE |
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WAIVER: I know that running a road race is potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risks associated with running in this event including, but not limited to, falls, contact with other participants, the effects of weather and temperature, traffic and the condition of the road, and all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I release The Center for Women, all Sponsors and their representatives from any and all claims or liabilities of any kind that may arise out of my participation in this activity even though liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission to the foregoing to use any photographs or any other records of this event for any legitimate purpose. I FURTHER AGREE TO RETURN AT THE END OF THE RACE THE COMPUTER CHIP THAT IS ISSUED TO ME, OR PAY A $30 REPLACEMENT CHARGE. Signature: Date: _____________________
Signature: Date: _____________________ (Parent or Guardian must sign if participant is under 18
year of age)
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