THIRD ANNUAL!!!

SHAMROCK SCURRY

        5K Benefit Run/Walk

& 1 Mile Fun Run (12 and Under)

 

DATE:          Saturday, March 18, 2006        

TIME:          1 Mile Fun Run: 8:15am;         5K: 8:45am

LOCATION:  Celebration Baptist Church - 3300 E. Shamrock,Tallahassee, Fl

                  (Killearn Subdivision)

SPONSOR:  Children of Ireland Group, Inc.

                   -a 501 (c )(3) non-profit organization

PROCEEDS BENEFITING:   MAKE A WISH FOUNDATION  AND

                                      THE CHILDREN OF IRELAND GROUP, INC.

AWARDS:

   BEAUTIFUL WATERFORD CRYSTAL TROPHIES 

   -Awarded to top overall 1st & 2nd male and female runners!!

   -Trophies to 1st , 2nd & 3rd male & female runners in

    5-year age groups!!

 

POST RACE EVENTS:  -PANCAKE BREAKFAST FOLLOWING 5K RACE (***NOTE:  $3 WITHOUT RACE #)

FURTHER INFO: Terry Ryan: terry@childrenofireland.us

                                            or call (850) 321-9352

        

Return entry forms to:   PLAY IT AGAIN SPORTS-1383 Capital Cir NE  OR mail to:  Box 13241, Tallahassee, FL 32317

Make checks payable to:  Children of Ireland Group, Inc. or CIG

(pickup runner packets at PLAY IT AGAIN SPORTS Starting

Wednesday, March 15th and By 5PM Friday, March 17TH)

 

 

PROCEEDS BENEFITING:

 

 

 

 

 

                       -----PLEASE COMPLETE, TEAR OUT, AND DROP-OFF TO BELOW 

                                        LOCATION OR MAIL TO BELOW ADDRESS----

 

---------------------------------------------------------------------------------------------------

 

 

Please Circle Applicable entry fee & circle t-shirt size (if wished):

      

  PRIOR TO MARCH 7TH

ON OR AFTER MARCH 7TH

SHIRT

UNDER 18

 

        18 & OVER

 

   UNDER 18

 

 18 & OVER

 

Circle

 

WITH T-SHIRT

 WITH T-SHIRT

 WITH T-SHIRT

WITH T-SHIRT

Small

 

      $10

             $15

       $15

      $20

Medium

 

  NO T-SHIRT

 NO T-SHIRT

  NO T-SHIRT

 NO T-SHIRT

Large

 

       $5

             $10

       $5

      $10

X-Large

 

 

 

 

 

 

 

 

 

 

(PLEASE PRINT LEGIBLY)   QUESTIONS?  CALL:  321-9352

Name:__________________________________________________________

   Age on 3/18/2006: _______________ Gender:_____Male    _____Female

   Telephone:_________________________

    E-Mail:______________________________________________________

    Address:____________________________________________________   

    City:________________________ State:______  Zip:________________   

 

How did you hear about Scurry:  ___Fleetfoot ____Chi Omega

__Flyer at other race __Flyer in local store  __Other____________        

 

 

Please Sign the “Release & Waiver” statement below and drop off w/check to:  

                 PLAY IT AGAIN SPORTS3183 Capital Circle NE

         OR mail to: The Children Of  Ireland Group, Inc., Box 13241, Tallahassee, FL 32317

An IRS 501(c)(3) Non-Profit Organization

I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able, physically fit and properly trained. I assume any and all risks associated with this event including but not limited to falls, contact with other participants, effects of weather, including heat and/or humidity, and traffic and the conditions of  the roads, all such risks being known and acknowledged by me.

I agree to abide by all decisions of the race officials relative to my ability to safely complete this run. I agree to not wear headsets, run with dogs, baby joggers, or strollers during the race. Knowing these facts and in consideration of your accepting my entry, I hereby, for myself, my heirs, executors, administrators or anyone else who might claim on my behalf, covenant not to sue, and waive, release and discharge all The Children Of Ireland Group, Inc., race officials, volunteers and all sponsors including their agents, employees, assigns, or anyone acting on their behalf from any and all claims or liability for death, personal injury or negligence or carelessness on the part of the persons named in this waiver. This Release and Waiver extends to all claims of every kind and nature whatsoever, foreseen or unforeseen, known or unknown. The undersigned grants full permission to The Children Of Ireland Group and/or agents authorized by the organization to use any photographs, videotapes, motion picture or an other record of this for any legitimate purpose.

 

Signature (parent if under 18)____________________________________________ 

 

 

Date:__________________________