| ABOUT THIS EVENT: Midway Professional Fire Fighters benefiting Muscular Dystrophy Association FOR INFORMATION ON THIS EVENT: Please Visit: www.racepensacola.com LOCATION: Midway Fire Station 1 (next to Winn Dixie) 1322 College Parkway Gulf Breeze, Fl 32563 FEES: Registration: (Online registration before online close date) 8K PS Team Individual Adult $20.00 Individual Child (15&under) $10.00 Public Service Team $40.00* Team entries must be submitted together. You may have up to six runners per team – the top four runners are scored for the team average. Make Checks out to Pensacola Race Management |
| March 7, 2010 - Start Time: 2PM |
AWARDS
Top 3 Male and Female in each age groups:
10 & Under, 11-15, 16-19, 20-24,25-29,30-34,35-39,40-44, 45-
49,50-54,55-59,60-64, 65-69, 70-74, 75-79, 80+
Top Public Service Team Award (Fire, Police, EMS)
For the fastest department
Walkers Overall – Top 5 Female and Top 5 Male (regardless of
age)
SHIRTS
To the first 200 per-registered runners!
Packet Pick Up
NEW BALANCE GULF BREEZE
824 GULF BREEZE HWY
GULF BREEZE, FL 32561
850-916-9700
Saturday (March 6, 2010)
3:00 PM – 6:00 PM
On-site Registration/Packet Pick Up
Midway Fire Department (Sunday March 7, 2010)
12:00 – 1:30 PM
Start Time: 2:00 PM
Top 3 Male and Female in each age groups:
10 & Under, 11-15, 16-19, 20-24,25-29,30-34,35-39,40-44, 45-
49,50-54,55-59,60-64, 65-69, 70-74, 75-79, 80+
Top Public Service Team Award (Fire, Police, EMS)
For the fastest department
Walkers Overall – Top 5 Female and Top 5 Male (regardless of
age)
SHIRTS
To the first 200 per-registered runners!
Packet Pick Up
NEW BALANCE GULF BREEZE
824 GULF BREEZE HWY
GULF BREEZE, FL 32561
850-916-9700
Saturday (March 6, 2010)
3:00 PM – 6:00 PM
On-site Registration/Packet Pick Up
Midway Fire Department (Sunday March 7, 2010)
12:00 – 1:30 PM
Start Time: 2:00 PM
Midway 8K
March 7, 2010
PAPER REGISTRATION FORM
SIGN ME UP:
Make Checks out: Pensacola Race Management
Circle One: Adult Run Child Run FF Team Walker
Individual Adult $20.00
Individual Child (15&Under) $10.00
Public Service Team $40.00
First Name: __________________________ Last Name: __________________________
Email: __________________________ Phone #:_________________________
Public Service Company(Fire Department, EMS, Police: ________________________________________
Address: _____________________________ City: __________________________
State: _________________ Zip: __________
T-Shirt Size: SM MED LG XL XXL Gender: Female or Male
Age on Race Day: ___________ Birth date:
Waivers and disclaimers
Waiver Statement: Entry is invalid if not signed. In consideration of the acceptance of this registration entry, I the
undersigned waive any and all claims from myself, heirs and successors and assume full and complete responsibility
for any injury or accident, which may occur during my participation in the event or while I am on the premises of the
event. I hereby release and hold harmless Midway Fire Department, Midway Fire District, Pensacola Race
Management, LLC, volunteers, sponsors, municipalities, promoters and all other persons and entities associated with
the event or their agents or employees, or otherwise. I will not enter and participate unless medically and properly
trained. I also know that although police protection will be provided, there may be traffic on the course route and will
take proper care. I assume the risk associated with this event, including but not limited to falls, contact with
participants, the effects of weather including high heat and/or humidity, and the conditions of the road, all such risks
being known and appreciated by me. During the event, I will not consume or be under the influence of any type of
alcohol or illegal drugs. I further grant my permission to use any photographs, videotape, motion pictures, recordings,
or any other record of this event. Fees are non-refundable. T-shirt size is not guaranteed. I have read the forgoing
and certify my agreement by this signature, and my parent’s/ guardian’s if under 18.
I understand that I may participate even if it is cold, hot, raining, snowing, windy and what nature will throw at me. The
we offer no refunds for this event and money raised will go to the MDA on behalf of the Midway Fire Station. It is up to
me to show up to the starting line.
By signing this document, I agree to the disclaimers and waivers listed on the registration.
Sign Name
Print Name
Date:
MAILING INFORMATION:
Mail this form to:
Pensacola Race Management
Midway 8K Entries
P.O. Box 10050
Pensacola, FL 32524
March 7, 2010
PAPER REGISTRATION FORM
SIGN ME UP:
Make Checks out: Pensacola Race Management
Circle One: Adult Run Child Run FF Team Walker
Individual Adult $20.00
Individual Child (15&Under) $10.00
Public Service Team $40.00
First Name: __________________________ Last Name: __________________________
Email: __________________________ Phone #:_________________________
Public Service Company(Fire Department, EMS, Police: ________________________________________
Address: _____________________________ City: __________________________
State: _________________ Zip: __________
T-Shirt Size: SM MED LG XL XXL Gender: Female or Male
Age on Race Day: ___________ Birth date:
Waivers and disclaimers
Waiver Statement: Entry is invalid if not signed. In consideration of the acceptance of this registration entry, I the
undersigned waive any and all claims from myself, heirs and successors and assume full and complete responsibility
for any injury or accident, which may occur during my participation in the event or while I am on the premises of the
event. I hereby release and hold harmless Midway Fire Department, Midway Fire District, Pensacola Race
Management, LLC, volunteers, sponsors, municipalities, promoters and all other persons and entities associated with
the event or their agents or employees, or otherwise. I will not enter and participate unless medically and properly
trained. I also know that although police protection will be provided, there may be traffic on the course route and will
take proper care. I assume the risk associated with this event, including but not limited to falls, contact with
participants, the effects of weather including high heat and/or humidity, and the conditions of the road, all such risks
being known and appreciated by me. During the event, I will not consume or be under the influence of any type of
alcohol or illegal drugs. I further grant my permission to use any photographs, videotape, motion pictures, recordings,
or any other record of this event. Fees are non-refundable. T-shirt size is not guaranteed. I have read the forgoing
and certify my agreement by this signature, and my parent’s/ guardian’s if under 18.
I understand that I may participate even if it is cold, hot, raining, snowing, windy and what nature will throw at me. The
we offer no refunds for this event and money raised will go to the MDA on behalf of the Midway Fire Station. It is up to
me to show up to the starting line.
By signing this document, I agree to the disclaimers and waivers listed on the registration.
Sign Name
Print Name
Date:
MAILING INFORMATION:
Mail this form to:
Pensacola Race Management
Midway 8K Entries
P.O. Box 10050
Pensacola, FL 32524