11.23.2013 - 7:30 AM - Madison, MS

1. Christmas On Ice
Duathlon / 5K / 1 Mile Fun Run
Saturday, November 23, 2013 @ 7:30am
Start/Finish – Baptist Health Madison Campus, 401 Baptist Drive, Madison, MS 39110
Optional packet pickup Friday, November 22 from Noon-4pm in foyer of building
Duathlon Entry - $45
5K Entry - $25
1-Mile Fun Run Entry - $10
Duathlon participants will
transition and continue on a
9-mile bike route
5K and Duathlon participants
all start together and run the
same route beginning at the
Madison HealthPlex
5K Awards
Male and Female Divisions
1st Overall / Master / GrandMaster
1st, 2nd, 3rd in age groups: 14 and under,
15-19,20-29, 30-39, 40-49, 50-59, 6O>
Duathloners will transition
again and complete a 1-mile
run. This same route will be
used for the 1-mile Fun Run
Duathlon Awards
Male and Female Divisions
1st Overall / Master / GrandMaster
1st, 2nd, 3rd in age groups: 19 and under,
20-29, 30-39, 40-49, 50-59, 6O>
1-Mile Fun Run
Boys & Girls in one division
1st, 2nd, 3rd in age groups:
6 and under, 7-9, 9-12
Gift Bag! A long-sleeve cotton t-shirt and Christmas ornament are guaranteed to participants registered by 11/15/3013
Entries 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)
T-shirt size: Youth M
5K Run
Youth L
Adult S
Duathlon
Adult M
1 Mile Fun Run
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 aforementionedare 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