the 2015 Run 5K Registration Form

Running for Hope 5K
Fun Run/Walk
Sat. June 20, 2015 9:00 a.m.
@ Kopf Family Reservation
Avon Lake, Ohio
3rd Annual Running for Hope 5K. Join fellow runners and walkers on a course starting and finishing
at Kopf Family Reservation in Avon Lake benefiting the Love Without Boundaries Foundation.
Course details:
Entry Fees:
Adult 5K Run/Walk - $20 Pre-registration / $25 day of race *Entry fee includes T-shirt (while supplies last)
Kids Fun Run/Walk - $10 Pre-registration / $15 day of race *Entry fee includes T-shirt (while supplies last)
(Kids = 12 and under)
*T-shirt size guaranteed only for those registered by June 5th
Kopf Family Reservation, 32649 Electric Blvd. Avon Lake, OH 44012
Registration: Race Day Registration and Packet Pickup begins at 6:45 a.m. at Kopf Family Reservation
Make all checks payable to: Love Without Boundaries Memo: Running for Hope 5K
Mail form and check to: 26405 Rechner Drive Westlake, Oh 44145
Mail in registrations must be received by Monday June 15, 2015
Registration: closes @9am on Thursday June 18, 2015.
Katie Grahlfs, Race Director Ph. 509-294-7867 OR [email protected]
Adult 5K - Top 3 Overall Men and Women, Kids Fun Run/Walk - Top 3 overall
Name: ______________________________________ Phone: _______________________________________
Address:_____________________________________ Date of Birth:_______________ (circle) M or F / Run or Walk
City:________________________________________ Email:________________________________________
State, Zip:____________________________________ T-Shirt Size: (circle one) S
I know that running a road race is potentially hazardous activity, which could cause injury or death. I will not enter and participate unless I am medically able and
properly trained, and by my signature, I certify that I am medically able to perform this event, and am in good health, and I am properly trained. I agree to abide by
any decision of a race official relative to any aspect of my participation in this event, including the right of any official to deny or suspend my participation for any
reason whatsoever. I attest that I have read the rules of the race and agree to abide by them. I assume all risks associated with running in this event, including but
no limited to: falls, contact with other participants, the effects of the weather, including high heat and/or humidity, traffic and the conditions of the road or trail, all
such risks being known and appreciated by me. I understand that bicycles, skateboards, roller skates or roller blades and animals are not allowed in the race and I
will abide by all race rules. Having read this waiver and knowing these facts and inconsideration of your accepting my entry, I, for myself and anyone entitled to act
on my behalf, waive and release the Running for Hope 5k, the Lorain County Parks, the city of Avon Lake, Love Without Boundaries and the Road Runners Club of
America, all event sponsors, their representatives and successors and all volunteers from all claims or liabilities of any kind arising out of my participation in this
event, even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. This waiver shall be binding on my
heirs, executors and/or assignees. I grant permission to all of the foregoing to use my photographs, motion pictures, recordings or any other record of this event for
any legitimate purpose.
Printed Name: _______________________
Signature:____________________________________ Date:________
I, the parent or legal guardian of the above name entrant, consent to my child’s participation in the described activity. I agree to be bound by the terms of the
above Release.
Printed Name: _______________________
Signature:____________________________________ Date:________
Mail to: Katie Grahlfs, Race Director, 26405 Rechner Drive Westlake, OH 44145