ASHLEY ANDERSON BENEFIT
5K AND 1 MILE FUN RUN/WALK
DATE:
PLACE:
Contact Info: Vicki Rogers vrogers@doddcityisd.org 903-456-6383
RACE TIME: 1 MILE BEGINS AT
5K IMMEDIATELY FOLLOWING 1 MILE
REGISTRATION AND CHECK-IN:
EARLY REGISTRATION DEADLINE:
ENTRY FEE: STUDENTS PRE-K THRU 12TH GRADE MAY ENTER BY PLEDGES OR $10.00 $15.00 AFTER MARCH 22
ADULTS: $15.00 OR $20.00 AFTER MARCH 22
Make Checks payable to: Ashley Anderson Benefit
AWARDS ALL ENTRIES WILL RECEIVE A T-SHIRT
NO DUPLICATION OF AWARDS
1 MILE 12 AND UNDER RECEIVE RIBBONS TOP 3 IN EACH AGE GROUP
AGE GROUPS 6 AND UNDER, 7-8, 9-10, 11-12 MALE/FEMALE
5K
*OVERALL MALE/FEMALE AND MASTERS MALE/FEMALE
*TOP 3 IN EACH AGE GROUP MALE/FEMALE WILL RECEIVE MEDALS
*AGE GROUPS: 8 AND UNDER, 9-10, 11-12, 13-14, 15-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
SCHOOL TEAMS
SCHOOLS WITH THE MOST DOLLAR AMOUNT OF PLEDGES WILL WIN A GIFT CERTIFICATE FOR THEIR PE DEPARTMENT
THE SCHOOL WITH THE TOP 10 TIMES TURNED IN FROM THEIR STUDENTS WILL RECEIVE A PLAQUE
CATEGORIES
PRE-K-5TH GRADE 6TH -8TH GRADE 9TH-12TH GRADE
ASHLEY ANDERSON BENEFIT
5K / 1 MILE FUN RUN
ENTRY FORM
All proceeds go to Dodd City High School coach, Ashley Anderson, to help her in her fight against leukemia. Thank you so much for your effort and support.
Mail to: Dodd City ISD Make Checks payable to:
Vicki Rogers Ashley Anderson Benefit
602 N.
Contact information: Vicki Rogers e-mail vrogers@doddcityisd.org
Cell # 903-456-6383
Fax# 903-583-9545
Name_____________________________________
Age (as of
School Team_______________________________ Grade______
Gender F__M__
Entry: 1 mile fun run / walk______ 5K_______
Shirt size: Ys___Ym____Yl____
S____M_____L_____XL____XXL_____
Address_________________________________
City__________________________________ State______Zip______
Phone#__________________________________
E-Mail__________________________
In consideration of the acceptance of this entry, I, the undersigned, assume full and complete responsibility for any injury or accident which may happen to me during the event known as Ashley Anderson Benefit 5K and 1 mile fun run/walk or while I am on the premises of the event, and I hereby release and agree to indemnify, defend and hold harmless the City of Dodd City, sponsors, promoters, and all other persons or entities associated with this event from all injuries and damages, or otherwise.
Signature:______________________________________
Date_________________
Parent or Guardian signature if participant is 18 or under_________________
