REGISTRATION FORM [Please complete one form for each participant.] To REGISTER ONLINE, go to: WWW.ACTIVE.COM & search for “Sprint into Spring 5K”
COMMONWEATH BANK & TRUST*
SPRINT INTO
SPRING
Full Name: __________________________________
RUN/WALK
Gender (Circle One): M or F Date of Birth: __________ Age on Race Day: ____ Street Address __________________________________
*Member FDIC
• ROSE SPONSOR •
• TULIP SPONSOR •
__________________________________ Email: ______________________________
COMMONWEATH BANK & TRUST*
SPRINT INTO
SPRING
Executive Group, Inc.
Phone: ______________________________ T’shirt Size (Circle One): Youth L Adult L
Adult S Adult XL
MIKA TYLER
Adult M Adult XXL
Agent
RUN/WALK *Member FDIC
REGISTRATION FEE: q $25.00 Individual q $35.00 Individual (after March 6) TEAM REGISTRATION [4+ RUNNERS]: q $15.00 Per Person / Team q $20.00 Per Person / Team (after March 6) TEAM NAME: __________________________ MEMBER 1:____________________________ MEMBER 2:____________________________ MEMBER 3:____________________________ MEMBER 4:____________________________
• IN-KIND SPONSOR •
• MEDIA SPONSOR • MARCH/28/2015 8:00 AM
(Catering Available)
• BENEFITING •
TOTAL: $__________ Make check payable to “E’town United Way Run/Walk”. *All participants must sign the race waiver on the reverse side of registration form. Mail or deliver completed form to: Tanasia Brashear 100 Chase Way, Suite 4, Elizabethtown, KY 42701
At CBandT, we give you the same advice, service and attention we would give our own families. Our skilled staff of banking experts always has your best interests at heart, and we take pride in fostering your success. To learn more about us, visit us online at www.CBandT.com.
OF CENTRAL KENTUCKY
WAIVER & RELEASE
COMMONWEATH BANK & TRUST*
SPRINT INTO
SPRING RUN/WALK
• WHAT WE DO •
*Member FDIC
• RACE COURSE • Date: 1-16-14 Not to scale
This is a certified race course starting and finishing in front of Morningside Elementary School on Morningside Drive in Elizabethtown, KY. The race is chip timed by iTIMEYOU.
Chip timing will be used for scoring the 5K RUN/WALK. Top runners will be recognized at the awards ceremony afterward. Race results will be posted at the race, as well as online and emailed within 24 hours after the race.
• PRIZES • Prizes will be given for the following categories:
Top 3 Overall – Male & Female Top 3 Overall – Group Top 3 Overall – Individual Age Groups: [10-19] [30-39] [50-59] [20-29] [40-49] [60 and up]
• IMPORTANT DATES & TIMES • • PACKET PICK-UP • Fri. March 27, 8:00 am–7:30 pm (CBandT Mortgage) Sat. March 28, 6:30 am (Morningside Elementary) • RACE DAY INFO • Participants should arrive at 7:00 am. Race begins at 8 am.
Route #9
• TIMING AND SCORING •
Last year, the United Way of Central Kentucky invested $651,612 in Hardin County programs and agencies that advance education, financial stability and health – the building blocks of a good quality life for all. Join us by supporting this organization and it’s efforts... Become a corporate sponsor of the CBandT Sprint Into Spring 5K!
• COMMUNITY IMPACT • • 173 corporate partners • 31 funded programs provided by 22 agencies • 112,658 services provided across the fivecounty region • BANK ON Program offered through 12 separate Financial Institutions at 48 locations to provide families with a second chance at financial stability • 24 community partners provide workshops, funding and/or instructors for BANK ON so participants can attend free of charge.
RACE PACKET PICK-UP Your race packet will be ready for pick-up on Friday, March 27, 2015 from 8:00 a.m. to 7:30 p.m. at the Commonwealth Bank & Trust Mortgage office – 100 Chase Way, Suite 4, Elizabethtown, KY 42701. If you have any questions regarding your packet, please contact Tanasia Brashear at 270.234.0299.
By signing this entry form, I release Commonwealth Bank & Trust Company, United Way of Central Kentucky, and the sponsors and operators of the “Sprint Into Spring 5K” from any claim of liability, illness, damage or injury suffered by me as a result of participation in, or traveling to and from this event. I understand that running or walking a road race is a potentially hazardous activity unless I am medically able and properly trained. I hereby certify that I am in such physical condition and in good health. I also give permission for free use of my name and picture in any account, broadcast or telecast of this event. Date: ____________ Printed Name: _______________________ Signature*: ________________________ [*If you are under the age of 18, the name and signature above must be that of your parent/guardian.]
By registering for this race, you are showing your support for the United Way of Central Kentucky and all of the wonderful community programs it helps to improve!!! We look forward to seeing you on Saturday, March 28!
