T-SHIRTS: T-shirts will be given out to all pre-registered entrants on the day of the race. Race Day entrants are not guaranteed sizes or availability.
TIME: 8:00 a.m. – Start of 1-mile race 8:30 a.m. – Start of 5K race 8:31 a.m. – Start of 5K racewalkers Race day registration & number pickup begins at 7:00 a.m.
AWARDS: st nd 1 Mile: Kids (13 & Under) Overall Male and Female; 1 , 2 place in age groups 5-under, 6-7, 8-9, 10-11, 12-13, 14-16 (male & female).
PLACE: Varsity Sports, 2021 Claiborne St., Mandeville Beautiful Course through Old Mandeville & Scenic Mandeville Lakefront ENTRY FEES: (checks payable to: Northshore Kiwanis) Pre-Registration: (Postmarked by September 30, 2016) $10.00 Pre-registered Student (high school and below) $20.00 All entrants (age 17 & over) Race Day Registration: $15.00 Student entrants (high school and below) $25.00 All entrants (age 17 & over) $20.00 Race Day no t-shirt entry fee will be available
5K: Overall Male & Female; Master (40 & over) Male & Female; st nd Overall Racewalker Male & Female and 1 , 2 Place in age groups 10 & under thru 70 & Over (male & female) SCHOOL SPIRIT AWARD: Special award to the school with the most registered participants (students, parents, and teachers!!) REFRESHMENTS: Post race refreshments, including local food and beverages will be available to all registered participants.
PRE-REGISTRATION: (Postmarked by September 30, 2016) th BY MAIL: Northshore Kiwanis C/O 15 Street Flyers 49 Karen Drive, Covington, LA 70433 IN PERSON: Varsity Sports (985.624.8200) ~ Sorry, no credit cards 2021 Claiborne St., Mandeville ON LINE: http://getmeregistered.com/5KiwanisForKids
Race Administered by: The 15th Street Flyers Running & Walking Club, A non–profit organization and the Northshore Kiwanis
Race Applications available at: www.15thstreetflyers.org FOR RACE INFORMATION CALL: Paul LeBlanc: 985-867-8334 or 985-249-9034 Diane Weiss: 504.460.2991 or 985.893.3684
Entry fees are non-refundable
********************************************************************************************************************** *DETACH BOTTOM PORTION AND RETURN WITH PAYMENT ____ $15.00 Student (high school & below) Race Day Registration Indicate school below ____ $25.00 All entrants Race Day Registration
___ $10.00 Student (high school & below) registered by 09-30-16 Indicate school below ___ $20.00 All entrants registered by 09-30-16
Race Number
____ $20.00 Race Day No T-shirt entry Checks payable to: Northshore Kiwanis Mail to: 15th Street Flyers, 49 Karen Dr. Covington, La. 70433 PLEASE PRINT CLEARLY: **ONE FORM PER PARTICIPANT** Entry fees are non-refundable
______________________________________ Last Name
________________________________ First Name
____ MI
________________________________________________________________________ Street Address/Apartment Number
_________________________________________________________ City, State, Zip Code
______ Sex M
Walker: ______ yes
______ Sex F
Shirt ____ Size: YS
____ YM
__________________________ Telephone Number ____ YL
____ AS
_____ AM
_________________ Date of Birth
_____ AL
_____ AXL
_____ AXXL
_______ Age
______ no
___________________________________ Email Address
____________________________________________________________ School Name
I know that running a road race is a potentially hazardous activity. I should not enter and run 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 the risks associated with running in this event including but not limited to fall, contact with other participants, the effects of weather, including high heat and/or humidity, traffic and other conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in considerations of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the Northshore Kiwanis, Kiwanis International, the Parish of St. Tammany, the City of Mandeville, the 15th Street Flyers and Varsity Sports and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all of the forgoing to use any photographs, motion pictures, recordings or any other record of this event for any legitimate purpose. ________________________________________________________________
SIGNATURE: by participant OR parent or guardian if under 18 yrs. old
________________________
DATE
