19th Annual
DEER DASH 5K Run/Walk and One Mile Fun Run! Saturday, November 5, 2016 Monticello, Georgia at the 50th Annual Jasper County Deer Festival Day of Event Registration/Check-in: Begins at 6:30 a.m. inside the Visitors’ Center, 119 West Washington Street, Monticello, Georgia Starting Times and Locations: 7:30 a.m. One Mile Fun Run...line-up on Funderburg Drive (at finish line/railroad tracks) 8:00 a.m. 5k Walk/Run………line-up in front of Jasper County Courthouse (shot gun start) Registration Fee: Individual $20.00 Pre Registration deadline is Noon, Saturday, October 22, 2016 Family $72.00 for four, $ 90.00 for five, $108.00 for six (immediate family) Business/Corporate $18.00 each (must register four or more in group) After Deadline Registration Fee: $25.00 Individual October 24, 2016 through Race Day (t-shirts not guaranteed) $20.00 each for Family or Business/Corporate (must register four or more in group) T-Shirts: All pre-registered runners are guaranteed an adult long sleeve shirt or a short sleeve youth shirt. Race day while supply lasts Award Categories: 5k Walk/Run: Overall Buck/Doe and Masters Buck/Doe. Awards 3 deep will be given in 5 year age groups from 10 and under to 70 and over. One Mile Walk/Run: First Place Finisher Award Buck/Doe to runner 10 years of age and under. Medals will given to all finishers under 15 years of age. More Information: Contact the Monticello-Jasper County Chamber of Commerce 706-468-8994 Email:
[email protected] Applications are available online at: www.jaspercountycoc.com Chamber of Commerce Cornerstone Sponsors: Abbey Hospice, Bank of Monticello, Central Georgia EMC, Representative Susan and Paul Holmes, Lewis & Malone Heating & Air Conditioning Service, Oxford Heating & Air, Inc., The Monticello News, Tricia Armistead, CPA, PC
2016 DEER DASH REGISTRATION FORM - ONE FORM PER PERSON NAME: _________________________________________________________________ ADDRESS: _____________________________________________________________
CITY: __________________________________________ STATE: _________ ZIP: _______________ PHONE: ___________________ EMAIL ADDRESS:___________________________________________ RACE: □ 5K □ 1 Mile □ Both PREFERRED SHIRT SIZE:
GENDER: □ Male □ Female
Adult Long Sleeve:
S
M
L
DOB: _____/_____/_____ XL (2X add $2.00)
Youth Short Sleeve: YS YM
In consideration of this entry, I waive all claims for myself and my heirs against any race official or sponsor for injury or illness which may directly result from my participation. I further state I am in proper physical condition to participate in this event. ___________________________________ Signature (parent or guardian must sign if participant is under 18 years of age) Check/Cash/Charge Amount Enclosed: $ __________________ Charge: Card Number:_____________________________________________ 3-Digit Security Code: ________Expiration Date:_________________ MAKE CHECK PAYABLE TO: Monticello-Jasper County Chamber of MAILING ADDRESS: Mo n t i c e l l o - J a s p e r C o u n t y C h a m b e r o f C o m m e r c e - P o s t O f f i c e B o x 1 3 3 , M o n t i c e l l o , G A 3 1 0 6 4
