Join us for our Third Annual Tuckerton UMC Missions Family 1 Mile Run/ Walk on Saturday, September 14, 201 to benefit Church Missions.

Registration 7:30-9:00 am ~ Race 9:00 am $15. per person prior to race day ~ $20. race day ~ family Sign Up $40 (up to 4 persons)

Little Egg Harbor Township Sports Complex [Across from Wawa] Route 539, LEH, NJ 08087

Complete and send registration form and entrance fee to: Debbie Allen (C/O UMC of Tuckerton) 134 N Green St., Tuckerton, NJ 08087

1st; 2nd; 3rd Place Overall Awarded Prizes (2 Groups 3-18 years of age and 18 and older)

1st; 2nd; 3rd Place All Age Groups – Receive Medal


REGISTRATION FORM

First Name: _______________________________

Last Name: _______________________________

Address:     __________________________________________________

City:    _________________________________

State:  _________________________________

Zip:      _________________________________

DOB    ______________________________________

SEX     M___     F___

Age Group:  (Circle One)

10 & under:

11-19;

20-29;

30-39;

40-49;

50-59;

60 & up

1 Mile Race 1 Mile Walk 1 Mile Race or Fun Walk: $15 until October 1st ~ 20.00 Day of Race Family Sign Up: $40 (up to 4 people) – $10/family member

T-Shirt Size (Circle One)

Adults   M    L     XL

Child T-Shirt Size    S    M     L

Please make checks payable to Tuckerton UMC Missions

Waiver of liability: Waiver must be signed by all entrants. In consideration of the acceptance of my entry, I, for myself or my minor child, hereby release UMC Missions representatives, sponsors, volunteers, organizer, and supporters from all claims, demands, suits, or actions, whatsoever in any manner for injuries or damages I may sustain as a result of my participations. I attest I have full knowledge of the strenuous nature of this event and am medically able to participate and I am willing to assume all risks involved. I also give permission for free use of my name and picture in any broadcast, release or print media account of this event without compensation.

Signature: (self) _________________________________

Or Guardian for: _________________________________