Florida RacePlace Jan-Feb 2012

Page 43

The 20th Annual Family Event Benefiting The Epilepsy Services Foundation, Inc.

Saturday, April 7, 2012 University of South Florida – Track & Field Stadium, 4202 East Fowler Avenue, Tampa, FL. 33620-8620 Distances/Race

5K Run/Walk “Off-Road Race”: 8:00 a.m.; 1 Mile Run/Walk: 8:45 a.m.; Fun Run: kids 6 & under: 9:15 a.m.

Awards

Directions

Take I-275 or I-75 to Fowler Avenue. Proceed to 50th Street. Turn to the north & proceed for ½ mile and turn left onto USF Holly St. Proceed until you come to USF Maple St. Turn left and come 3 blocks. Parking is across the street from the stadium.

Sponsors – Gold

DoubleTree Guest Suites – Tampa Bay Dole Fruits, USF, WQYK 99.5 FM

Sponsors – Silver

Bay City Chiropractic Clinic, Feet First, Panera Bread, Sweet Tomatoes, Tampa General Hospital, Tampa Legal Copies, Applied Image Group Printing, Reel Animals

Sponsors Bronze

Friends of ESF, Active.com, Einstein Bagels, Kobie, Scott & Zeke Pierce, Road I.D., Runners World Anne Schwanz Boeckh (Boeckhdesigns.com), Stadium Toyota, The Strain Family & Friends, B&B Sports, Brown’s Trophies

Race Results

Go to www.coolrunning.com or www.runningintheusa.com

Race Party

Commemorative Book

4 Ways To Register

Custom designed t-shirt guaranteed to pre-registered participants Post-race food, beverages & runner/family-oriented booths Visit with Ronald McDonald and the Easter Bunny Raffle prizes for kids and adults You can pre-order your Hare Racing Experience Commemorative Book. Call 813-374-8907 or e-mail: torth@epilepsysf.org 8 ½x11 Bookcloth Cover: $44.75. Page Print 12”x12”: $7.27 or Page Print 8”x8”: $6.20. (All prices include shipping & tax). Payment due on or before day of race. Please make check out to ESF. On-line: 1. http://www.active.com/5k-race/tampa-fl/20th-annual-hare racing-experience-5k1milefunruns-2012

5K: Overall Male/Female & Overall Male/Female Masters (40 & up) & top 3 male/female in each standard age groups (9 & under to 75+) 1 Mile: Kids top 3: 5 & under, 6-7 & 8-9

(CREDIT CARD ACCEPTED AT THIS SITE)

Free Entry

2. Visit ESF at www.epilepsysf.org/hare-racing-experience.htm and sign up. 3. Visit Feet First in Tampa & St. Petersburg and sign up. 4. Mail your registration form to HRE. Recruit and register 4 runners/walkers for the 5K or 1 mile and your registration is free.

2012 HRE INDIVIDUAL REGISTRATION FORM (Please Print) Postmarked by 4/4/12 Registration after 4/4/12  Certified 5K run/walk…$15  Certified 5K run/walk…$20  1 mile run/walk…$10  1 mile run/walk…$15  Fun Run: 6 & under…$5 (t-shirt)  Fun Run: 6 & under…$5 (t-shirt)  Donation: $___________  Donation: $____________ T-shirt Size:  S  M  L  XL Name

Address City Phone E-Mail Age Day of Race  M  F

State

Zip

WAIVER: I hereby release the Epilepsy Services Foundation, Inc., Tampa Bay Runners

and all sponsors, organizers and associate entities, be they individuals or organizations, singly and collectively, of all blame for injury, misadventure, harm, loss, or inconvenience suffered as a result of my participation in this event. I hereby grant permission for the free use of my name and photograph in any broadcast, promotions or account of this event.

2012 HRE TEAM OF 5 REGISTRATION FORM (Please Print) Postmarked by 4/4/12 Registration after 4/4/12  Certified 5K run/walk…$60  Certified 5K run/walk…$80  1 mile run walk…$40  1 mile run/walk…$60  Fun Run: 6 & under…$5 (t-shirt)  Fun Run: 6 & under…$5 (t-shirt)  Donation: $_____________  Donation: $_____________ Number of t-shirts:  S  M  L  XL Team: Name: _____________________________________Age_____ Shirt Size_____ Name: _____________________________________Age_____ Shirt Size_____ Name: _____________________________________Age_____ Shirt Size_____ Name: _____________________________________Age_____ Shirt Size_____ Name: _____________________________________Age_____ Shirt Size_____ (Ages Day of Race) Team Leader Name Address City State Zip Phone E-Mail Number of  M  F

WAIVER: We hereby release the Epilepsy Services Foundation, Inc., Tampa Bay

_________________________________________________________________________ Signature (Parent/Guardian if under 18) Date

Runners and all sponsors, organizers and associate entities, be they individuals or organizations, singly and collectively, of all blame for injury, misadventure, harm, loss, or inconvenience suffered as a result of my participation in this event. We hereby grant permission for the free use of our names and photographs in any broadcast, promotions or account of this event. ________________________________________________________________________ Signature for Team (Parent/Guardian if under 18) Date

Make checks payable to: Epilepsy Services Foundation, Inc. 4628 N. Armenia Ave., Tampa, FL. 33603-2706 Phone: 813-374-8907 Fax: 813-443-5546 E-Mail: torth@epilepsysf.org Website: www.epilepsysf.org

Make checks payable to: Epilepsy Services Foundation, Inc. 4628 N. Armenia Ave., Tampa, FL. 33603-2706 Phone: 813-374-8907 Fax: 813-443-5546 E-Mail: torth@epilepsysf.org Website: www.epilepsysf.org

January/February

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