F: ____ Zip: _______________________
PLEASE DELIVER TO: Current Resident
Fort Myers Track Club at PO Box 60131 Fort Myers, Florida 33906-6131.
Non-Profit Organization U.S. Postage PAID Permit No. 259 Fort Myers, FL
Please make check payable to the Fort Myers Track Club, entry forms may be mailed to the
T-Shirt Size: S __ M __ L __ XL __
Telephone: ____________________________ Email: _____________________________________
City: ___________________________ State: _____________
Birth Date: ____________________ Age (day of race) _______________
Official Entry Form
Benefitting Officer Damien Garcia Cape Coral Police Department
Last Name: _________________________ First Name: __________________________
Fort Myers Cops & Joggers 5K
Race managed by the Fort Myers Track Club Fort Myers Track Club Cops & Joggers 5K Run PO BOX 60131 Fort Myers, FL 33906-6131
Saturday, October 24, 2009 Centennial Park Downtown Fort Myers 7:30 a.m.
Proceeds from this event will benefit Officer Damien Garcia of the Cape Coral Police Department. Officer Garcia was seriously injured in a motorcycle accident while on duty. He is still recovering from his injuries.
Course & Event:
The race begins and ends at Centennial Park along the river in historic downtown Fort Myers and will cross the Edison Bridge. The 3.1 mile run will venture through some great scenery in the city of Fort Myers and will be a great experience for all. Refreshments will be served following the race.
Before October 22nd: After October 23rd: Race Day, October 24th
Race Packet Pick-Up:
Race packets may be picked up on Friday, October 23rd from 10am to 4pm at Run Florida, located inside Fitness On The Move, at 13211 McGregor Blvd. Fort Myers, FL 33907. Inside the Training Ground. The phone number is 239-437-3488
Register By Mail:
Mail check and entry form to: Fort Myers Cops & Joggers PO Box 60131 Fort Myers, FL 33906-6131 Make checks payable to the Fort Myers Track Club
Register On Race Day:
Day of event registration begins at 6:30am at Centennial Park in Downtown Fort Myers.
The first 400 participants will receive a goodie bag with an event t-shirt and sponsor M&F Overall M&F Masters 40 & over M&F Grandmasters 50 & over M&F Senior Grandmasters 60 & over
Age Group Awards: 3 deep male and female
11-under 12-15 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 & over
Unregistered runners, unauthorized vehicles, bicycles, skateboards, rollerblades/skates and baby joggers are prohibited. Hot and humid conditions may exist. Drink plenty of fluid before, during and after the race.
Seeking 2009 Race Sponsors, please contact Denise Egolf at firstname.lastname@example.org or 321-7723 for additional information
Signature of runner/walkerâ€”Signature of parent/guardian (if under 18)
Printed name of runner/walker
RELEASE FORM (MANDATORY) INCOMPLETE OR UNSIGNED ENTRY FORM CANNOT BE ACCEPTED. I know that participating in this running/walking event is a potentially hazardous activity. I agree not to enter and participate unless I am medically able and properly trained. I agree to abide by any decision of an event official relative to my ability to safely complete the event. I am voluntarily assuming all risks associated with participating in this running/walking event including but not limited to falls, contact with other participants, spectators or others, the effects of weather, including that cold and/or humidity, traffic and rough trail conditions of the course, all risks being known and appreciated by me. Having read this Waiver of Liability and knowing these facts, and in consideration of your acceptance of this application, I, for myself and anyone entitled to act on my behalf, waive and release the organizers, officials, volunteers, sponsors and employees of the City of Fort Myers, the Fort Myers Track Club, Fort Myers Police Department and Road Runners Club of America each and any of their representatives and successors, from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of persons named in their waiver. By submitting this application I agree to the above Waiver of Liability. The Fort Myers Track Club reserves the right to deny registration to any applicant. The applicant must adhere to all Fort Myers Track Club policies. If the event is cancelled for any reason or I am denied entry due to my falsification of any information or due to my failure to pick-up my race number prior to the race, I hereby donate my entry fee to the event host. I acknowledge that this waiver will be used by the event hosts and that it will govern my actions and responsibilities at this event and shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. For the safety and enjoyment of all, the course is restricted to registered participants and race officials only. Unregistered participants, unauthorized vehicles, skateboards, roller-skates, baby/joggers and dogs are strictly prohibited. For your own safety, we discourage the use of radio/recorder headphones. The risk of running in high temperature and humidity is inherent to Florida activities. Be sure to drink plenty of fluids before the start of the event and remember to replace your fluids on the course and after the finish.
Goodie Bags: $20.00 $25.00 $30.00