Mercer Health
MARIA STEIN COUNTRY FEST
16th Annual 5K Run/Walk
Sunday June 29, 2008 9:00 A.M.
TIME: 5K Run/Walk begins at 9:00 AM. Sharp. The start and finish will be on St. Johns Rd. - Maria Stein, near the Country Fest Grounds. Registration opens at 7:00 AM closes at 8:30 AM.
COURSE: A flat out & back course over rural roads. No Roller Blades. Course record: 15:26 Brendon Moody
MALE and FEMALE DIVISIONS:14 and under, 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60 and over
5K RUN/WALK AWARDS: A plaque to the top three overall male and female finishers, medals to the top three places of each age division, male and female. Award ceremony begins immediately after the race under the far south entertainment tent, door prizes will be drawn at the award ceremony. Must be present to win door prizes.
REFRESHMENTS: Free at finish line for all participants including Dannon Yogurt and Power Aid drink. Food stands open at 10:00. Restroom facilities available on the picnic grounds.
ENTRY-FEE for RUN/WALK: Pre-registration with a T-shirt is $12.00, without shirt is $8.00. Race day registration is $10.00 and does not include a shirt. Pre-registrations must be postmarked by June 13, 2008.
Make checks payable to: Country Fest 5K Run.
RETURN remittance and entry to:
Elaine Wolters 2191 Oak St. Maria Stein, OH 45860
For information call: Elaine Wolters 419-925-4620 or email justdewit@roadrunner.com
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Name:___________________________________________________(official use) Bib #________
Address:_______________________________________________________________
City, State, Zip:_________________________________________________________
Phone Number:(_________)____________________________e.mail______________
***Age As Of June 29, 2008_________ please mark race choice:
MALE _________FEMALE________ 5K-Run/Walk______
SELECT T-SHIRT SIZE
youth: LARGE adult: SMALL MEDIUM LARGE X-LARGE XX-Large ($13.00) NO SHIRT
if no size is indicated, an X-large will be issued
******Waiver of Liability (Must be signed to participate) ******
In consideration for my being permitted to participate in the Mercer Health Maria Stein Country Fest 5K run, I hereby release, discharge and agree to hold free and harmless the Country Fest Committee, Event Sponsors, Marion TWP. Park and its committees and any volunteers and each of them together with their successors, assigns, officers, agents and employees from any and all liability for injuries to property or person suffered by me as a result of my participation in the Mercer Health Maria Stein Country Fest 5K run. By my execution of this waiver, I verify that I am physically fit and have sufficiently trained for the completion of this event and my physical condition has been verified by a licensed medical doctor. This release shall be binding upon my heirs, executors and administrators.
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signature (must have to process) Parent/Guardian Signature if participant is under 18