Jingle Bell Jog December 6, 2014 5K Run / 2K Walk Benefits the Upper Dublin girls lacrosse team and the Katie Samson Foundation for spinal cord research Participants receive jingle bells, long sleeve t‐shirts, and post race refreshments! The race starts and finishes at Upper Dublin High School; the route is a certified 5k course that winds through beautiful Fort Washington neighborhoods.           Chip timing! $25 entry fee must be postmarked by November 30th $30 entry fee after November 30th including day of race $15 entry fee for children 12 years old and under Rain or shine event, no refunds Awards presentation for the 5K run following the race Race begins at 9:00am, registration begins at 7:30am at the Upper Dublin high school cafeteria Timing and finish line services by Run The Day Questions? Email: udjinglebellrun@gmail.com or call 267‐388‐0529 Register online at www.runtheday.com (small service fee will be charged) Awards presented to the top 3 male and female finishers overall and the top 3 finishers in each age group. Male and female age groups: U14, 15‐19, 20‐29, 30‐39, 40‐49, 50‐59, 60+ Registration form First Name_________________________ Last Name_______________________________ Address_________________________________________ City_____________________ State______ Zip___________ Gender: M F Age as of December 6th________ Date of birth___________________ Run_______ Walk________ Adult T shirt size: S M L XL XXL (T Shirt guaranteed if we receive registration by November 22nd) Youth T shirt size: S M L Email: __________________________________ Phone:____________________________ Waiver: I acknowledge that running or walking in a 5K race/and or 2K walk can be a potentially hazardous activity. On behalf of myself, my heirs, executors, administrators, successors, and assigns, I hereby waive and release all rights and claims for damages which I may have against you or your assigns, the municipalities in which the event occurs, or anyone connected with this event, for any and all injuries or illnesses which I may suffer as a result of taking part in the event. I grant my permission to use my name or any audio or visual recording for any lawful purpose. I understand that volunteers will be on hand to guide participants, but roads may be open to traffic. Signature:____________________________________ Date:____________________________ Parent or guardian if under 18 years of age:___________________________________________ Mail completed registration form to: Jingle Bell Jog, 300 Tally Ho Drive, Maple Glen, PA 19002 Checks Payable to: UDHS Girls Lacrosse