2015 Mail-in Registration Form

Race Information
The Howard County Public School System is excited to present its second annual 5K & 1 Mile Fun Run. For more information, visit www.hcpss5k.com.
Who: This event is open to all HCPSS students, their families and the community.
What: 5K (3.1 miles) or 1 mile Fun Run.
When: Sunday, October 11, 2015. The 1-mile fun run to start at 8 a.m.; 5K race to start at 8:15 a.m.
Where: Event will start and finish in front of the Sheraton Hotel in downtown Columbia (10207 Wincopin Cir, Columbia, MD 21044)
5K foot runners must be at least 5 years old. There is no age limit for children riding in strollers. Stroller participants are required to register for this
race.

Entry & Wavier Form

Each participant must complete and submit an entry form with payment. Mail-in registrations must be received by 4:30 p.m., Wednesday, October 7.
Make checks payable to The Howard County Public School System.

$20.00 per 5K participant

$8.00 per 1-mile fun run participant

Mail Form to: Howard County Public School System, attn: Emily Bahhar, Public Information, 10910 Clarksville Pike, Ellicott City, MD 21042

Race Materials and Packet Pick Up visit www.hcpss5k.com for up-to-date information
All participants can pick up race packets at:
Friday, Oct 9 from 5:00 p.m. 8:00 p.m. at Feet First Sports*.
Saturday, Oct 10 from 10:00 a.m. 5:00 p.m. at Feet First Sports*.
Sunday, Oct 11, RACE DAY, 6:00 a.m. 7:45 a.m. at the race area in front of the Sheraton Hotel.
*Athletes may pick up packets for friends and family. A copy of the participants photo ID and letter signed by the participant is required. Feet First Sports
is located at 6420 Freetown Road, Columbia, MD 21044.

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HCPSS Community 5K & 1 Mile Fun Run Registration Form
Each participant must fill out and sign form to participate in the 5K & 1 Mile Fun Run. One participant per form.
Name of participant (print clearly): _____________________________________________________________________________________________
Gender (circle):

Male Female

Date of Birth: ____________________

Email Address (print clearly): __________________________________________________________________________________________________

Emergency Contact Name & Phone (print clearly): _________________________________________________________________________________
I am participating in (circle only one): 5K / 1 Mile Fun Run

T-Shirt Size (circle below):

Youth S / Youth M / Youth L/Adult XS / Adult S / Adult M / Adult L
Adult XL / Adult 2XL / Adult 3XL

What school/HCPSS office do you represent? ______________________________How did you hear of this event? ______________________________
Are you a (circle): HCPSS student / parent / other family member / staff / community member
Liability Waiver (must be signed to participate in event): In consideration of the acceptance of my entry, I for myself, my executors and assignees, do
hereby release and discharge the Howard County Public School System, race organizers, volunteers and officials, and all sponsors, their representatives and
successors from all claims and liabilities of any kind arising out of my participation in this event, including injury, loss or damage to personal property, or
the carelessness on the part of the persons named in this waiver. I have full knowledge of the risks involved in this event and I am physically fit and
sufficiently trained to run/walk in this event. Further, I grant permission and release to all of the foregoing to use any information, photographs, or
recordings of this event for legitimate purposes.
Signature of participant (parent or guardian if under 18 years old):
_____________________________________________________________________________________ Date __________________