5k Run/Walk hosted by the Rochester Hills Government Youth Council

Transcription

1 5k Run/Walk hosted by the Rochester Hills Government Youth Council to benefit the Saturday, June 13, 2015 Bloomer Park Rochester Hills, Michigan 8:30 a.m. 10:30 a.m. Registration Brochure

2 Blessings in a Backpack is a program offered to students in the Rochester Community Schools who qualify for the free/reduced lunch program. Blessings provides 6 meals to be distributed in school on Friday to feed the student over the weekend. This program will run during the school year only. Packing Each week, during the school year, volunteers will pack at The First Congregational Church at 1315 N. Pine St. in Rochester. The coordination of volunteers will be the responsibility of the steering committee. We will pack every Wednesday starting at 4:00 PM or 6:00 PM depending on the availability of the group volunteering to pack that week. The packing is done in an assembly line process with the food being packed in a Meijer bag and placed in a plastic bin labeled with each participating school. The packing takes approximately 1.5 hours. Once the food is placed in the bins, Rochester Community Schools transportation will deliver the food to each school on Friday. The empty bins will be returned to the church on Monday. This program would not be possible without volunteers like you! We are seeing unprecedented numbers of families in need right here in Rochester Hills. I can't thank you enough for considering helping with Blessings. You can go on the national web site for more information on this program, blessingsinabackpack.org. -2-

3 Race-Day Schedule of Events: REGISTRATION: - Pre-Registrations encouraged and will be accepted through 3 p.m. Wednesday, June 10, Registrations accepted until 8:30 a.m. on day of event. - Day of Race Registration opens at 7:30 a.m. and runs to 8:15 a.m. All Registration Forms must be accompanied by a signed Waiver of Liability-Sporting Event Participant (Page 5) for each adult registrant. Registration for Minors must be accompanied by a signed Accident Waiver and Release of Liability-Sporting Event, Parent-Guardian Waiver for Minors (Page 6). Include a separate waiver for each registrant. PACKETS: T-shirts and timing bibs will be provided at check-in on the morning of the race. START: Run/Walk begins promptly at 8:30 a.m. and runs through 10:30 a.m. REFRESHMENTS: Snacks and drinks available at the Finish Line. Water available at stations along the event course. FOR ADDITIONAL INFORMATION: Contact (248) or visit the RHGYC Website at Pre-Registration Fees* 15 & Over..$25.00* (w/t-shirt**) 14 & Under $15.00* (w/t-shirt**) 10 & Under.FREE (No T-Shirt) Extra T-Shirts/Shirts for 10 & under.. $7.00 each** *Note: Add $5 if registering on day of event. **T-Shirts are available while supplies last! The Course: Bloomer Park, located at the north end of John R Road in Rochester Hills, provides a great setting for the 5k with rolling terrain and gorgeous scenery. This is an off road cross-country course with some small hills and paths consisting of grass and dirt surfaces. Sponsorship Opportunities Available: Consider becoming a Title, Finish Line, Gold or, Silver See the Sponsorship Registration Page for details. -3-

4 5K Run/Walk June 13, 2015 Bloomer Park Registration: **ALL REGISTRANTS MUST ALSO COMPLETE THE WAIVER OF LIABILITY SEE PAGES 5 & 6** MINORS WILL NOT BE ALLOWED TO PARTICIPATE WITHOUT WAIVER SIGNED BY PARENT OR GUARDIAN How did you learn about the 5K? (Please check one:) City Website City Cable Channel Runners Website Friend/Family Coach Blessings in a Backpack Newspaper Flyer Runner/Walker #1 Last Name First Name MI T SHIRT SIZE Specify Adult S/M/L/XL Date of Birth (MM/DD/YYYY) Age on Race Day M( ) F( ) Street Address City, State Zip Telephone Number Address Runner/Walker #2 Last Name First Name MI T SHIRT SIZE Specify Adult S/M/L/XL Date of Birth (MM/DD/YYYY) Age on Race Day M( ) F( ) Street Address City, State Zip Telephone Number Address Participant Registration Total*: $15* 14 & under $25* 15 & Over Age 10 & under FREE (no T-shirt) parent must list child on registration and submit waiver Additional Shirt/Shirt for 10 and under Add $7 for each: (Specify size(s) ) I cannot participate, but would like to make a donation in the amount of $ $ $ *T-Shirts available while supplies last, on a first-registered basis. Registration deadline for guaranteed T-shirt: May 25, Participants not pre-registered may not receive a shirt. *Note: Add $5 if registering on day of event. **MAKE ALL CHECKS PAYABLE TO COMMUNITY FOUNDATION OF GREATER ROCHESTER MEMO LINE: RHGYC 5K** MAIL OR DELIVER TO: ROCHESTER HILLS GOVERNMENT YOUTH COUNCIL/5K RUN/WALK OFFICE OF THE CITY CLERK, CITY OF ROCHESTER HILLS, 1000 ROCHESTER HILLS DR., ROCHESTER HILLS, MI 48309

5 Waiver of Liability Sporting Event Participant 5k Run/Walk hosted by the Rochester Hills Government Youth Council - Proceeds will benefit Blessings in a Backpack. **INCLUDE A SIGNED WAIVER FOR EACH PARTICIPANT** **Parent-Guardian of Minors, please complete Waiver on Page 6** I acknowledge that this athletic event is an extreme test of a person s physical and mental limits and carries with it the potential for death, serious injury and property loss. The risks include but are not limited to, those caused by the terrain, facilities, temperature, weather, condition of athlete s equipment, vehicular traffic, actions of other people including but not limited to volunteers, spectators, coaches, event officials and event monitors, and/or producers of the event and lack of hydration. If applicable, hazards may be caused by water currents or waves and other water related hazards. I hereby assume all the risks of participating in this event. I certify that I am physically fit, have sufficiently trained for participation in this event and have not been advised otherwise by a qualified medical person. I acknowledge that this Accident Waiver and Release of Liability form will be used by the City of Rochester Hills, the Rochester Hills Government Youth Council, Blessings in a Backpack, and the event holders, sponsors and organizers and that it will govern my actions and responsibilities at said events. In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors and assigns to: (A) Waive, Release and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter accrue to me, including as to my traveling to and from this event, the following entities or persons: The City of Rochester Hills, the Rochester Hills Government Youth Council, Blessings in a Backpack, its elected and appointed officials, employees and volunteers, and representatives and agents, and others working or acting on behalf of the City of Rochester Hills, the Rochester Hills Government Youth Council, Blessings in a Backpack, and to the extent permitted by law (B) Indemnify and Hold Harmless the entities or persons mentioned in this paragraph from any and all liabilities or claims made by other individuals or entities as a result of or relating to my attendance at or participation in this event. I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident and/or illness during this event. I hereby certify that I have read this document and understand and agree to its content. Name: Signature: Age: Date: -5-

6 Accident Waiver and Release of Liability Sporting Event Parent-Guardian Waiver for Minors 5k Run/Walk hosted by the Rochester Hills Government Youth Council Proceeds will benefit Blessings in a Backpack **INCLUDE A SEPARATE SIGNED WAIVER FOR EACH MINOR PARTICIPATING** The undersigned parent and natural guardian or legal guardian does hereby represent that he/she is, in fact, acting in such capacity and agrees to the extent permitted by law to save and hold harmless and indemnify each and all of the parties referred to below from all liability, loss, cost, claim or damage whatsoever which may be imposed upon or incurred by said parties because of the participation of the minor in the event shown, and releases said parties in this regard on behalf of both the minor and the parents or legal guardian, as well. Minor: Age: Parent or Legal Guardian: Signature: Date: Parties: The City of Rochester Hills, the Rochester Hills Government Youth Council, Blessings in a Backpack, its elected or appointed officials, employees and volunteers and representatives and agents. Event: 5k Run/Walk hosted by the Rochester Hills Government Youth Council Proceeds will benefit Blessings in a Backpack. -6-

7 5K Run/Walk June 13, 2015 Bloomer Park Sponsorship Opportunities: *Title Sponsor: $1,500 donation *Gold Sponsor: $500 donation (2 Max for Title Sponsor(s)) Name or logo prominently displayed on front of event T-Shirt Name or logo on all event-related marketing materials Name or logo on runner giveaways Exclusive signage at registration Logo and link on Rochester Hills Website Table display at event Four race registrations Name or logo displayed on back of event T-shirt Logo and link on Rochester Hills Website Table display at event *Silver Sponsor: $250 donation Name or logo displayed on back of event T-shirt Logo and link on Rochester Hills Website *Finish Line Sponsor: $750 donation Name or logo on runner giveaways Name or logo prominently displayed on back of event T-shirt Logo on Finish Line Banner Logo and link on Rochester Hills Website Table display at event *Sponsorship levels are suggestions and can be customized to fit your business. Please note: Any sponsorship monies received after printing deadlines may not be included in printed materials. Contact Name Business Name (as it should appear in promotions)* Web Address (for promotional materials) Street Address City/State/Zip Address Contact Phone Sponsorship T-shirt Size S/M/L/XL Level of Sponsorship: Title Sponsor $ Finish Line* $ Gold*: $ Silver*: $ Special Contributor: (amount included) $ Check enclosed for the amount of $ * Finish, Gold, and Silver sponsors, please include a black-and-white logo, if available. Please note that any logos received after printing deadlines may not be included on T-shirt or banner. THANK YOU FOR YOUR GENEROUS SUPPORT! Please make checks payable to: Community Foundation of Greater Rochester and include RHGYC 5K in memo line Mail or deliver to: ROCHESTER HILLS GOVERNMENT YOUTH COUNCIL/5K RUN/WALK Office of the City Clerk, City of Rochester Hills 1000 Rochester Hills Drive, Rochester Hills, MI If you have questions, please contact Charnele D. Sanders, Youth Council Liaison