Rabbit Run 5K, - Central Carolina Community College

Presented by: Chatham County Farm Bureau

Rabbit Run 5K, Children s Fun Run & Dog Run Saturday, March 29, 2014 • 8:00 AM Pittsboro Campus 764 West Street • Pittsboro, NC

Entry Fees: $20 early registration fee (on or before March 1) $25 after March 1 (including day of race) $10 Children’s Fun Run $10 Dog Run to the top overall male • Awards will be given plus the top male and and female finishers, h age group. eac female finishers in goodies will be • T-Shirts and other fun pre-register. o wh se tho to le availab event will go to help • Proceeds from this deserving students for fund scholarships al needs at CCCC. and other education

For more information, call (919) 718–7230. 5K

www.cccc.edu/RabbitRun

CENTRAL CAROLINA

COMMUNITY COLLEGE FOUNDATION, INC.

Rabbit Run 5K Saturday, March 29, 2014 Registration Form You can also register online at: http://its-go-time.com/register

Runner Entry Information (please print) Name: ______________________________________________________________________________ Age: ________________ Address: ______________________________________________________________ City: ______________________________ State: _________________________________________________________________ Zip: _______________________________ Email: ________________________________________________________________ Sex:

Male

Shirt Size: S

Female

M

L

(circle one)

XL

2XL

(circle one)

Race & Payment Select Race Event:

________ 5K __________Fun Run

$20 - Early Registration fee (on or before March 1) $25 - After March 1 including day of race $10 - Children’s Fun Run

_________ Dog

$10 – Dog Run

______________________________ Dog’s Name

****Please be prepared for “clean up as you go” for your pets please**** (All dog entry fees will be designated to the Veterinary Medical Technology Program with the CCCC Foundation)

Payment: __________Check (make checks payable to: “CCCC Foundation”)

________ Cash ________ Credit Card (Register Online at: http://its-go-time.com/register) Mail Form & Payment to: CCCC Foundation | Attn: Emily Hare | 1105 Kelly Drive | Sanford, NC 27330

Release I know that running/walking/obstacles in a road race could be a potentially hazardous activity. I should not enter and run/walk/obstacles unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the obstacle run/walk. I assume all risks associated with running/walking/obstacles in any Go Time! events by Hackman Events LLC. This includes - but not limited to - falls, contacts with other participants, the effects of the weather including high heat and/or humidity, low temperature, traffic and conditions of the road, all risks being known and appreciated by me. I also declare that my dog is immunized for rabies and I understand the risks of dog interaction/contact. Having read this release and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf or on behalf of my estate, waive and release GO TIME, HACKMAN EVENTS LLC, CENTRAL CAROLINA COMMUNITY COLLEGE, CHATHAM COUNTY FARM BUREAU, CCCC FOUNDATION, COLIN AND MICHELLE HACKMAN and all sponsors of the race, any other persons assisting with the race, the officers, Board, Board members, agents, servants, employees, and their successors and assigns of each and every of the above from all claims or liabilities of any kind arising out of my participation in the run/walk even though the liability may arise out of negligence or carelessness on the part of the persons referred to in this waiver. I also grant permission for the use of any photographs, motion pictures, recordings or any other record of my participation in this event for any legitimate purpose. I understand that if the race is canceled because of circumstances beyond the control of the race committee and sponsors, including, but not limited to unsafe weather conditions or governmental ban, my entry fee will not be refunded. This release must be signed by all participants and/or by the parent or guardian if participant is under 18.

Signature: ____________________________________________________________________ Date: _____________ (Signature of parent or guardian if participant is under 18)

Print Name: __________________________________________________________________ Questions? Please contact: Emily Hare | 919-718-7230 | [email protected]