The Survivor Run
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        11th Annual Survivor Run

 Print off the form below and mail it in.

  Phil’s                  
        11th Annual Survivor Run
Theme: *** Do you want a new Bike?  *** 
Date:           Sunday:  April 8, 2018 -----   5K at 8:00 am   
What:       5K Race with T-shirts & lots of prizes. All run on the Ma Pa trail.
 NEW Starting at Williams St on the Ma Pa trail
Packet Pick up:          Sat April 7 at Charm City Run 1 – 4 & Sun 4/8 at Williams St. at 7 am 
NEW “Grand Prize” – New Bike from CIVIC Cyclery in Bel Air – THANK YOU!
Awards:     Cash awards;  $100, $50, & $25      Overall  1-3   Male & Female
        Normal age groups:   0-19 20-29 30-39 40-49 50-59 60-69  70+
Benefits both:        The Stroke Network & the Rasac Scholarship fund.  

 
2018 Survivor Run   --- Race Application ----
In consideration of your acceptance of my entry , I hereby, for my heirs, my executors, and administrators, waive any and all rights and claims for damages I may have against Rasac, Harford County Dept of Parks and Recreation, RRCA, the Race Directors, Charm City Run, the Town of Bel Air and their agents and sponsors for any and all injuries suffered by me during the 11th Annual Survivor Run, I hereby, by my signature, acknowledge reading and understanding this clause, and attest and verify that I am aware of the hazards associated with this event and am physically fit and have trained sufficiently for this event. I have my parent’s permission; signature below if I am under 18 years of age.

 
Name: ________________________________________ Age _____ Gender   M or F   Date:  ____________

Signature:_____________________________ Signature of Parent (If under 18)______________________


Address: ______________________________    City:___________________  State: ____    ZIP:_________

E-Mail: _____________________________________    Phone:___________________________

Circle or check the cost below and mail entries payable to:               “Phil’s Race”  to:

Price:   $25.00 ________  Till  3/15/2018        Phil Anderson
         
After:        3/ 15/2018  
$35.00  ______    Race Day:  $50.00 ____ 625 Roland Ave     Bel Air Md    21014

  
Circle T-Shirt size:       S   M   L    XL    XXL         Race site:    www.survivorrun.com

 
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