Christmas On IceDuathlon / 5K / 1 Mile Fun Run

Saturday, November 23, 2013 @ 7:30am

Start/Finish – Baptist Health Madison Campus, 401 Baptist Drive, Madison, MS 39110Optional packet pickup Friday, November 22 from Noon-4pm in foyer of building

Gift Bag! A long-sleeve cotton t-shirt and Christmas ornament are guaranteed to participants registered by 11/15/3013Entries are non-refundable. In the event of cancellation Christmas On Ice tickets will be given in lieu of refunds.

---------------------------------------------------------------------------------------------------------------------------------------------Checks payable to and entry to: Christmas On Ice, P.O. Box 2253, Madison, MS 39130

Race entered: (Circle One) 5K Run Duathlon 1 Mile Fun Run

T-shirt size: Youth M Youth L Adult S Adult M Adult L Adult XL Adult XXL

Name__________________________________________________________________________ Age on race day:___________ Sex:__________

Address_________________________________________________________ City_____________________________ ST______ Zip____________

Phone___________________________________________ Email ____________________________________________________________________The undersigned certifies that the participant is fit to take part in the event and assumes all risks involved. In consideration of the acceptance of this application to part in the event, the

undersigned releases Christmas On Ice, Baptist Health Systems, other sponsors, promoters, contractors, and any individuals associated with the event from any liability for injury, illness or death suffered by a participant and their representatives. I further agree that none of the aforementioned are responsible for the loss of personal items connected herewith. I also

authorize the use of my name and picture may be used for publicity. Entries are non-refundable. In the event of cancellation Christmas On Ice tickets will be given in lieu of refunds.

_____________________________________________________________ _____________________________________________________________Participant Signature Parent/Guardian if participant is under 18 years old

5K and Duathlon participants all start together and run the same route beginning at the

Madison HealthPlex

Duathlon participants will transition and continue on a

9-mile bike route

Duathloners will transition again and complete a 1-mile run. This same route will be used for the 1-mile Fun Run

Duathlon AwardsMale and Female Divisions

1st Overall / Master / GrandMaster1st, 2nd, 3rd in age groups: 19 and under,

20-29, 30-39, 40-49, 50-59, 6O>

5K AwardsMale and Female Divisions

1st Overall / Master / GrandMaster1st, 2nd, 3rd in age groups: 14 and under,15-19,20-29, 30-39, 40-49, 50-59, 6O>

1-Mile Fun Run

Boys & Girls in one division1st, 2nd, 3rd in age groups:

6 and under, 7-9, 9-12

5K Entry - $25 1-Mile Fun Run Entry - $10Duathlon Entry - $45