Isaiah 53-5K Run/Walk and Fun Run April 9, 2011

Is a benefit run/walk for cancer. All process will go to American Cancer Society, Relay for Life of Polk County. Please run/walk with us to help find a cure and let’s make cancer HISTORY!

But he was pierced for our transgressions, he was crushed for our iniquities: the punishment that brought us peace was upon him, and by his stripes we ARE healed. Isaiah 53:5

Location: Race will begin at First Baptist Church Rockmart, 311 E. Elm St. Race will go out onto Silver Comet Trail and finish back up at the church.
Time: 5K 8:00 A.M., 1 Mile Fun Run 9:00 A.M.
Register: @ http://isaiah53-5k.webstarts.com or with below form
_______________________________________________________________________________
Isaiah 53-5K Run/Walk and Fun Run-April 9, 2011
Must receive by April 1, 2011
Return entry form to First Baptist Church Rockmart 311E. Elm Street, Rockmart, GA. 30153
Checks payable to Melissa Mathis…Contact Phone Number: 404-680-0488
Circle all that apply: 5K Run/Walk: $25.00 1 Mile Fun Run: $15.00
T-Shirt Size: Adult S M L XL T-Shirt Size: Youth S M L

Name: ________________________________________Age:_________ Date of Birth:___________ Gender: M F

Address: ____________________________________City:_____________________ State:_________ Zip:_______

Phone: _______________E-mail ___________________Amount:___________ 

                                                                                   WAIVER
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 voluntarily assume all risks associated with running in this event, including , but not limited to: falls, contact with other participants, the effects of the weather, traffic, and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts, and in consideration of your accepting my entry, I for myself and anyone entitled to act on my behalf, waive and release First Baptist Church Inc. the organizers of the race, its employees, agents, officers, members, volunteers or affiliates as well as all sponsors, their representatives and successors, from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver, except claims or liability arising out of willful or wanton acts, gross negligence, or intentional misconduct. I certify that I am 18 years of age or older, or that I am the Parent/Guardian of the entrant and am granting permission for him/her to participate.

Signature________________________________________   Date_____________________

Parent/Guardian (if under18) _________________________   Date_____________________