Saturday, April 21, 2018

Ballenger Creek Middle School

5525 Ballenger Creek Pike, Frederick, MD 21703

Packet Pick Up and Onsite Registration:

Friday, April 20, 5:00pm - 7:00pm BCMS Gym

Saturday, April 21, 7:00am- 8:00am BCMS

Race Day Schedule:

Flag Raising Ceremony/Star Spangled Banner 8:00am

Warm Up by Christine with Resilience Yoga 8:05am

1K Kids Fun Run 8:10am

5K Run/Walk Start 8:30am

Award Ceremony 9:30am

Post Race Celebration

DJ!

Bounce House

Post race treats

Awards Ceremony for Top Finishers!

Raffle Prizes Announced

3 Easy Ways to Register to Run or Walk with Us:

1) Fill out the registration form on the BACK SIDE of this paper and return this registration form with payment to

BCMS. Attention Mrs. Smith by April 1st. Checks can be made out to BCMS.

2) Go to www.runsignup.com and register online. Search for BCMS Kids Cure 4 Cancer 5K/Fun Run

3) Late Race Day registration available starting at 7:00am.

4) After race expenses, all Proceeds of the Race will be sent to “St Jude’s Hospital” for Cancer Research.

Please register early!! The 1st 200 registrants get a BCMS Kids Cure 4 Cancer 5K t-shirt.

????QUESTIONS???

Contact Terry Smith at

Therese.smith@fcps.org

Or 240-236-5700

Thank you to our race sponsors to date.

BCMS Kids Cure 4 Cancer 5K/1K

Fun Run

Want to be a sponsor?

Contact Terry Smith at

Therese.smith@fcps.org

D and D Drilling

3909 Cap Stine Rd. Fred.

Participant Name (s) Age Grade Level

(if applicable)

Gender

(M/F)

5K

Or

1K

Fee Check box if you

want us to send

race packet home

with your child.

Address: ___________________________________________ Total Amount: ____________

___________________________________________ Email: _______________________________________________

Phone: _____________________________________________

Release: All participants MUST sign the waiver to participate.

I, the undersigned participant, intending to be legally bound, do hereby for myself and my heirs, executors, administrators, and assigns,

forever waive, release and discharge any and all rights, claims and actions for damages that I may have, or that may here-after accrue to

me against the Maryland PTA including all units and councils, and all of their officers, directors, members and grant permission for the

use of any photographs or recording of this event for legitimate purposes.

____________________________________________________ ____________________________________________ __________ Participant #1 Printed Name Signature Date

____________________________________________________ ____________________________________________ __________ Participant #2 Printed Name Signature Date

If the participant is under the age of 18:

I am the legal guardian of Participant and hereby consent to his/her participation. I have read the foregoing release and agree on behalf

of myself and the Participant to its terms.

____________________________________________________ ____________________________________________ __________ Parent/Guardian Printed Name Signature Date

—————————————————————— ONE FORM PER FAMILY PLEASE ————————————————————

ENTRY FEES Advance by 4/1 4/1-4/21

Adult (12 & Older) $20.00 $25.00

Student (Under 12) for 1K $5.00 $7.00

Students (Under 12) for 5K $10.00 $10.00

Family Pack (Includes all chil-

dren in immediate family and

up to 2 adults )

$50.00 $55.00

Family Sponsor (not able to run

but would like to sponsor par-

ticipants in financial need)

$20.00 $25.00

BCMS Kids Cure 4 Cancer 5k/Fun Run

Thank you for choos-

ing to take part in this great community event at Bal-

lenger Creek Middle School. Please fill out the form so

that it can be easily read. Please send completed

form to BCMS with payment BY April 1. Checks

can be made payable to BCMS. PLEASE be sure to

read and sign the waiver. Other registration options

include.

1.) Go to www.runsignup.com and register online. Search

BCMS Kids Cure 4 Cancer 5K.

*** Email address request. By checking this box, you

agree to us sharing your email address with Frederick

Steeple Chasers to email you ONLY future race event info.