Application for : 2010 BEACH SWEEP 5K ON 9/18/10 HIGHLIGHT AND PRINT THE APPLICATION AND RETURN -
OR THE PREFERRED WAY BY ENTERING ON LINE AT WWW.GRANDSTRANDRUNNER.COM
SWEEP 5K RUN
SATURDAY, SEPTEMBER 18, 2010
DISTANCE: 5KM. (3.1 MILES)
TIME: 9:00 AM
START/FINISH: Beach Front at the 2nd Ave South beach front park
SPONSORS: KEEP NORTH MYRTLE BEACH BEAUTIFULCOMMITTEE, WENDY'S, TROXELL CHIROPRACTIC, COASTAL ENGRAVERS, HOT STACKS PANCAKE HOUSE, COASTAL TIMING AND MYRTLE BEACH MARATHON
ENTRY FEE: Pre-Registration- $22 (by Fri., Sept 17th.) Race day- $27
COURSE: Out and back on the “WORLD’S WIDEST BEACH”
AWARDS: TOP 3 MALES & FEMALES OVERALL, TOP 3 EACH AGE GROUP:
15 & UNDER,16-20,21-25,26-30,31-35,36-40,41-45,46-50,51-55,56-60,61-65,66-70 &71+
REGISTRATION: Race day registration and packet pick up from 7:30-8:45 AM, At beach front park. 2ND AVE SOUTH IN NORTH MYRTLE BEACH
Make checks payable and mail to: BEACH SWEEP 5K RUN
802 13TH AVE. SOUTH
NORTH MYRTLE BEACH,SC 29582
FOR MORE INFO: Contact Dr. Jim Troxell @ (843) 272-1717 or JTROXELL@SCCOAST.NET____________________________________________________________________________
NAME:____________________________ SEX: M F AGE:___DOB__________
ADDRESS:_______________________
CITY:____________________________ STATE:________ ZIP:_______
PHONE__________________ T-SHIRT SIZE: SMALL MEDIUM LARGE X-LARGE
WAIVER AND RELEASE: In consideration and acceptance in the 2010 BEACH SWEEP 5K RUN, I , and my heirs and my assigns waive any and all claims to which I may become entitled for injury and damage, and hereby release all sponsors, organizations, organizers, representatives, their agents, and employees, and any other person(s) assisting in putting on the event from any claims for damage incurred by me as a result of participation in or traveling to or from this event. I further state that I am in proper physical condition to complete in the 5 k run. I also give permission for the free unrestricted use of my name and or picture in any broadcast, telecast or written account of the event.
SIGNED:_________________________________ DATE: ________________
PARENT OR GUARDIAN IF UNDER 18: ____________________________________
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