Transcript Document
The Maryland-National Capital Park and Planning Commission, Department of Parks and Recreation, Prince George’s County Thursday, April 2, 2015 Watkins Regional Park 301 Watkins Park Drive, Upper Marlboro, MD 20774 Registration: 5:30pm Walk/Run Begins: 6:45pm Registration includes a t-shirt, a “Glow Gear” bag, access to the course, and refreshments. Proceeds from this event will benefit the BLING FOR BLUE Scholarship Advanced Registration Encouraged! Visit www.pgparks.com and click on E-Store (under about Parks and Recreation) to register. For more information, call: 301-249-7200; TTY: 301-218-6768 *Not a timed event ~ This event is a fun run to raise funds and awareness for Autism. All Ages Welcome! All Ages Welcome! Watkins Regional Park 301 Watkins Park Drive, Upper Marlboro, MD 20774 Thursday, April 2, 2015 Registration: 5:30pm Walk/Run Begins: 6:45pm 5K GLOW WALK/RUN: Ages 15 & under must be accompanied by a paid adult registrant. This inclusive M-NCPPC special event is designed for community members of all abilities. Please note that direct supervision/assistance will not be provided. NOT a timed race. Registration Fees Early Registration Fee = $10 / person, ages 6 & up (Early Registration prices end March 26th; online registration closes March 31st) After March 26th = $15 / person, ages 6 & up (Please print clearly, complete form, sign, and bring on race day.) 5K Glow Walk/Run for Autism - April 2, 2015 _____________________________________________________ Name Liability Release: I know that running is a potentially hazardous activity. I should not enter or run in this event 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 this race including, but not limited to, falls, contact with other participants, the effects of weather, the conditions of the road and traffic on the course, all such risks being known and appreciated by me. Having read this waiver and knowing these facts, and in consideration of your acceptance of my application, I, for myself and anyone entitled to act on my behalf, waive and release The M-NCPPC and all sponsors, their representatives and successors 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 person named in this waiver. _____________________________________________________ Email _____________________________________________________ Address _____________________________________________________ City State Zip _____________________________________________________ Phone Birth Date Age on Race Day _____________________________________________________ Gender M F Youth Shirt Size S M L Adult Shirt Size S M L XL XXL _________________________________________________________________________ Participant’s Signature Date _________________________________________________________________________ Parent’s Signature (if under 18 years)