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5K Run
Re-Run 5K

SATURDAY, APRIL 17th AT 7:30 AM
Squid Lips in Downtown Eau Gallie ~ Melbourne, FL

TIMETABLE: Friday, April 16th 10:00 am – 6:30 pm
Packet Pickup & Registration at Running Zone
across from Wickham BCC Pavilion

Saturday, April 17th – Downtown Eau Gallie (Squid Lips)

  • 6:00 am           Packet Pickup & Registration

  • 7:15 am           Late Registration for 5k ends

  • 7:30 am           Re-Run 5k Start

  • 8:30 am           Kids Fun Run start - FREE!

5KRun/Walk Until 4/16  Race Day
Adult   $25.00  $30.00
12 & Under $15.00  $20.00
Team Reg. $20.00/runner N/A

Pay online!!

Full Name
Address
City
State
Zip
Phone
Email
MaleFemale
Date of Birth
Age on Race Day
Team Name, if applicable
Adult Shirt
Student team?  YesNo
Student Team Name
Youth Shirt

I HAVE READ THE ABOVE RELEASE AND UNDERSTAND THAT I AM ENTERING THIS EVENT AT MY OWN RISK. Please check box if you are in agreement


INCOMPLETE OR UNSIGNED ENTRY FORMS WILL NOT BE ACCEPTED

In consideration of my entry form being accepted, I intend to be legally bound, and do hereby, for myself, my heirs and executors, waive and release all rights and claims for damages which I may have or may hereafter accrue to me against the Junior League of South Brevard, Inc., Running Zone Race Management, Inc, and the officers, agents, employees, representatives, successors, and assigns of each, as well as all sponsoring organizations and their representatives, for any and all damages or injuries which may be

sustained or suffered by me in connection with any association or entry or participation in the Re-Run 5K Run. If I should suffer injury or illness, I authorize the officials of the race to use their discretion to have me transported to a medical facility, and I take full responsibility for this action. I attest that I am physically fit and have sufficiently trained for the competition of this event. I hereby grant full permission to any and all of the foregoing to use any photographs, videotapes, or any other record of this event for

any purpose whatsoever. I HAVE READ THE ABOVE RELEASE AND UNDERSTAND THAT I AM ENTERING THIS EVENT AT MY OWN RISK.


A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING 1-888-435-7352 WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL OR RECOMMENDATION BY THE STATE. THE REGISTRATION NUMBER FOR THE JUNIOR LEAGUE OF SOUTH BREVARD INC. IS SC-00169. NO PROFESSIONAL SOLICITORS ARE RETAINED IN THE FUNDRAISING ACTIVITIES OF THE JUNIOR LEAGUE OF SOUTH BREVARD, INC.


THE JUNIOR LEAGUE OF SOUTH BREVARD, INC. IS AN ORGANIZATION OF WOMEN COMMITTED TO PROMOTING VOLUNTARISM, DEVELOPING THE POTENTIAL OF WOMEN AND IMPROVING COMMUNITIES THROUGH THE EFFECTIVE ACTION AND LEADERSHIP OF TRAINED VOLUNTEERS. ITS PURPOSE IS EXCLUSIVELY EDUCATIONAL AND CHARITABLE.

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