Transcript Slide 1

Granite City Police Department 1st
Annual Jail Break 5K Run/Walk
To Benefit BackStoppers
Saturday, May 14th, 2011
8:30 a.m. Start Time
Entry Fee: $20.00 In Advance
$25.00 Day of Race
COURSE: We will start in front of the Granite City Police Department and end in downtown Granite City where the Melting Pot Market will be
open.
AWARDS: The top 3 overall winners will receive medals. The top 3 finishers in each age division (both male and female) will receive medals.
REGISTRATION AND PACKET PICK-UP: Pre-race pick up Friday, 3-13-11 at GCPD from 2:00pm – 7:00pm. Day of race registration begins at
7:00 am.
ENTRY: All pre-registered participants are guaranteed a T-shirt. For more information, please contact Jenna DeYong or Eric Klumpp @ 4519760.
Name_______________________________________________
Male__ Female__
Age_____ Runner_____ Walker_____
Address_____________________________________________
T-Shirt Size __________ (Add $2.00 to race fee if XXL or larger)
City__________________________ State____ Zip___________
Make Checks Payable to: PB & PA Unit 15 and mail to: Jailbreak 5K, 2330 Madison Ave. Granite City, IL 62040
In consideration of this entry, I waive all claims for myself and my heirs against any and all officials or sponsors of the GCPD “Jail Break 5K Run/Walk for injury
or illness which may directly or indirectly result from my participation. I further state that I am in proper Physical condition to participate in the event.
__________________________________________________________________
__________________________
RUNNER’S SIGNATURE or parent's signature if under 18 years of age
Date