1. The First Annual Chamber & EDC
Firecracker 5K & Family 1 Mile Fun Run
What 5K Run/Walk
Kids 1 Mile Fun Run-Ages 12 & Under
Where Begins & Ends at The Chamber & EDC
342 Washington Ave. (CB&S Bank Building, Downtown Greenville)
Awards Ceremony immediately following Family Fun Run
(Male and Female)
Overall, Masters 40+, Grand Masters 50+
Top 3 Age Group: 19 and under, 20-29, 30-39,
40-49, 50-59, 60+
Fun Run – Top 3 Age Group: 6 & under, 7-9, 10-12
Fees Registration Fee is Non-Refundable &
Includes T-Shirt
(T-shirt sizes guaranteed during pre-registration)
$10 Fun Run
$20 Pre-Registration OR $25 Registration Fee after June 19
$50 Family Rate (Family of four w/ children under 12)
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MAIL COMPLETED REGISTRATION FORM & REGISTRATION FEE TO:
The Chamber & EDC of Washington County, P.O. Box 933, Greenville, MS 38702
For More Information Contact Debra Wintory at 662.378.3141 or dwintory@thechamberandedc.com.
NAME: _________________________________________________________
ADDRESS: ______________________________________________________
CITY/ST/ZIP: __________________________________________________
PHONE: ________________________________________________________
E-MAIL: ________________________________________________________ Circle One:
Family Member #1: __________________________________________Age: _______ Shirt Size: __________ 5K Run 5K Walk Fun Run
Family Member #2: __________________________________________Age: _______ Shirt Size: __________ 5K Run 5K Walk Fun Run
Family Member #3: __________________________________________Age: _______ Shirt Size: __________ 5K Run 5K Walk Fun Run
As consideration of acceptance of the entry, I hereby waive any and all claims for myself and my heirs against The Chamber & EDC of Washington County and
each of its agents, servants, officers and employees for injury or illness which any directly or indirectly result in my participation in the event, I further agree
to save and hold The Chamber & EDC harmless ad agree to indemnify each said person against any liability for any loss, costs, injury, or damage to persons or
property which may arise by virtue of undersigned engaging in the race. I further state that I am in proper physical condition to give my permission for the
free use of my and/or minor child’s name and/or picture in any broadcast, telecast or other accounts of this event. I further attest and certify that my minor
child and/or I are physically fit and have sufficiently trained for competition in this event.
Signature: ________________________________________________________________________ Date: ______________________________
Save a Stamp! Register online www.racesonline.com.
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Thursday, July 4, 2013
Race Day Schedule
7:00 a.m. Race day
registration & race packet
pick-up for pre-registered
participants
8:00 a.m. 5K Run
8:05 a.m. 5K Walk
FUN RUN WILL BEGIN
AFTER 5K RACES
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AGE (As of 7/04/2013):____
SEX: M F
EVENT (Circle One): 5K Run 5K Walk
Shirt Size: (Adult) S M L XL XXL
(Youth) s m l xl