CURE LMS 5K RUN/WALK

Taking strides towards a cure for LeioMyoSarcoma Cancer Saturday, September 28, 2013 10:00 AM Winton Woods Hamilton County Park 10245 Winton Road Springfield Township, OH 45231
Location signup at Winton Woods Ladybug Landing from 8:30 to 9:45 AM Runners start at 10:00 AM, Walkers at 10:05 AM. No animals allowed.

All money raised goes to the National LeioMyoSarcoma Foundation

Medals to the 1st three finishers in each running/walking group! Groups Children 12 & under, Teens 13-18, Adults 19-64, Seniors 65+ Name: _________________________________________________________________ Address: _______________________________________________________________ City/State/Zip: _____________________ Telephone #: _____________________ Sex: Male or Female (circle one) Walking or Running (circle one)
Individual entry fee: $20.00 until 9/21fee after 9/21 is $25.00 except 14 & under - $10.00 No entry fee with $50.00 or more on the sponsorship form. T-shirts available while supply lasts. Parking is included for pre-registrants If paying by check, please list the check # ____________ Online registration is available at www.getmeregistered.com/curelms **Make checks payable to: NLMSF and put CureLMS5K on the memo line. Send to: Cure LMS 5k P. O. Box 482 Maineville, OH 45039
Participant Waiver: I know that participating in a 5K event is a potentially hazardous activity. I should not enter and participate 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 course. I assume all risks associated with this event including, but not limited to: falls, contact with other participants, the effects of the weather, including high heat and humidity, traffic, wet or uneven surfaces and the conditions of the road, 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 , for myself and anyone else entitled to act on my behalf, waive and release Cure LMS 5K and its officers, the National LeioMyoSarcoma Foundation (NLMSF) and its agents, and all event sponsors and their representatives and employees 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. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose.

email address: _______________________ Age on race day: _______________

Emergency contact: ______________________

Signature: _______________________________________________ Date: _____________________ All Participants Sign (Parent or guardian if under the age of 18) NLMSF.org curelms5k.com email: info@curelms5k.com