Nov 18 2012
Caravel Academy Jefferson Awards
Hosted by Caravel Academy’s Jefferson Awards Team: promoting volunteerism & supporting the community
Benefiting Nemours/A.I. Dupont Hospital for Children’s PICU expansion and restoration
November 18, 2012
Start: Caravel Academy Track
2801 Del Laws Rd.
Bear, DE 19701
Wheel measured (3.1 mi.) course through the beautiful Caravel Academy Campus & surrounding neighborhood
Refreshments include: Starbucks Coffee. Variety of fruit and water provided by Safeway of People’s Plaza
THANK YOU TO OUR GENEROUS GOLD LEVEL SPONSOR:
YOLICIOUS OF PEOPLE’S PLAZA!!!
Preregistration entry fee -- $20.00 received by Nov. 14th; $25.00 after Nov. 14/day of race
Check one circle below:
o 5k Road Race
o 5K Non-Competitive Walk
o Caravel Student
M & F Age Groups First & Second
Overall M &F, 13 & Under,14-18,19-29,30-39,40-49,50-59,60+over;Caravel Student Upper M & F, Caravel Student Middle/Lower M & F
What is your t-shirt size? REGISTER EARLY. (First 75 Runners receive a t-shirt) (check one below)
o ADULT SM
o ADULT MD
o ADULT LG
Make checks payable to: Caravel Academy Jefferson Awards
Mail form and payment to the address below:
Please allow time for postal delivery to ensure registration.
c/o Molly Sewell
2801 Del Laws Rd.
Bear, DE 19701
Name (please print) (One entry form per person):
Male______ Female______ Date of Birth_____________ Age_______
Daytime phone: __________________Email: _________________________ Emergency Contact______________________________________
Unconditional release and waiver of liability, assumption of risk and indemnity agreement
In consideration for permission to participate in the Kids 4 Kids Run/Walk on the date of the event I, the undersigned, or person participating in race for myself:
1) I acknowledge the hazardous nature of road running. In addition, I am qualified both physically and mentally to participate in such an event. Further, I acknowledge race shall be conducted over areas which contain traffic, paved and non-paved surfaces subject to elements and other various weather conditions including freezing. I further agree that if at any time the event appears to be unsafe, I will immediately discontinue participation.
2) I acknowledge the road running involves risks and potential serious bodily injury including permanent disability, paralysis and death. These risks may be caused by my own actions or inactions, the actions or inactions of others involved in the race, the actions or inactions others in the surrounding community not involved in the race, or other actions beyond control of race staff some of which include: high winds, rain, hail, heat, wild animals, dogs, falling objects, bicycles, and other motor operated machinery. I, the participant, fully accept and assume all such risks and responsibility for losses, costs and damages I incur as a result of participation in the Kids 4 Kids 5k Run/Walk.
By signing below, I release and agree not to sue, indemnify and hold harmless Caravel Academy Inc., D. M. Peoples Investment, R. C. Peoples Inc., all volunteers, sponsors, race support staff, Nova Timing Systems, and others present on race course and adjacent areas. I have read this agreement, fully understand its terms and acknowledge I have given up many rights by signing. I have signed below of my own freewill not under duress or assurance of any nature. I, the undersigned, intend this to be a complete and unconditional release of all liability to the fullest extent allowed by law. Further, if any portion of this agreement is found to be invalid that the balance shall remain in full force and effect. Any bullying, arguing or becoming belligerent with director, volunteers and other participants shall result in immediate removal from results with no refund, as well as, potential criminal/civil liability. The undersigned shall also BE REQUIRED TO HAVE A GOOD TIME ~ IT'S FOR CHARITY, REMEMBER?
Signature of Athlete (Parent’s Signature if under 18 years of age)
In accordance with RRCA rules, no strollers or animals allowed on race course for the safety of runners and walkers.