1. Coalition for the homeless Registration Form
2008 Homeward Bound Take steps to end homelessness last name_____________________________________
first name_______________________middle initial___
5K Race/Walk
Join celebrity co-chairs WDrB tV’s Barry Bernson
and the Courier-Journal’s angie fenton at the address_______________________________________
first annual homeward Bound 5k race/Walk to
end homelessness. this is the Coalition’s largest
______________________________________________
fundraiser and is for serious runners, casual City___________________state ____Zip Code________
walkers and families. our efforts are needed now
more than ever before. today one child in every Phone number__________________________________
Jefferson County classroom is homeless. through
legislative and educational efforts as well as your Cell Phone______________________________________
donations, the Coalition for the homeless will end
email address (for online confirmation)
homelessness in our community.
_______________________________________________
age on race Day________
o runner o Walker o Wheelchair
5K o male
t-shirt size:
o female
o small o medium o large o Xl o XXl
Payment: o mC o Visa o CheCK
Register Early & Save The Start Make it a team effort! Card #______________________________________
register online at the homeward Bound 5k race/ if you are interested in participating as a team, exp: ____/______ 3 Digit security code _________
www.louhomeless.org or by mail Walk begins at 9 a.m. on saturday, visit our website, www.louhomeless.org, for
before saturday, september 6, september 20, 2008 in Cherokee Park. details. signature ___________________________________
2008, for only $25 per person. enter Cherokee Park from lexington
road to the start of the race at Cochran
late registration and race Day
Dog run. Participants will run/walk the Waiver
registration is $35 per person.
scenic loop through the park. Prizes By checking the box below, you agree, warrant and covenant as follows: i
Participants under age 18 enjoy Winners (top men and women runners) receive know that running a road race is a potentially hazardous activity. i should
a $5 off youth discount. gift certificates in the following amounts from not enter and race unless i am medically able and properly trained. i
Race Day Parking & More Kroger: assume all risks associated with running in this event including, but not
race Day registration is Park free at southern Baptist theological
limited to: falls, contact with others, the effects of the weather and other
located at the start of the race seminary at 2825 lexington road. louie the 1st place winners $75 unknown circumstances. i have read and understand the waiver.
and opens at 8 a.m. entry fee is payable lightning Bug will greet you. face painting,
to homeward Bound 5krace/Walk. We accept bottled water and fresh fruit will be available. 2nd place winners $50
masterCard® or Visa®. or send your completed
registration, signed waiver and entry fee check to: 3rd place winners $25
ms. Kathy Beach, homeward Bound event Chair,
1st independence Bank, Po Box 206309, louisville, KY 40250. signature ___________________________________
Date _______________________________________
Saturday, September 20, 2008, 9 a.m. signature of Parent or Guardian if Participant is under age 18.
www.louhomeless.org
LARGE FRONT DESIGN
2 color on white shirt
(sponsor logos on back) LEFT SLEEVE WITH GET YOUR MESSAGE OUT!
SWIRL AT WRIST
SECURITIES (1 color)
Mark C. Naber Graphic Design, Illustration and Animation
Anita Swain Tyler 312 Exchange Avenue
(502) 896-1073 Louisville, Kentucky 40207
FAX (502) 895-0982 anita.tyler@insightbb.com
