Date(s) - 10/07/2017
9:30 am - 10:30 am
The 4th Annual Shillelagh 5K
In cooperation with the Jersey Shore Running Club and Bar Anticipation
Net Proceeds go to support the Club’s Charitable giving throughout the year:
Thanksgiving Food Drive, College Scholarship Fund, Christmas Toy Drive
& Helping Local Individuals and Families in Need
DATE: Saturday, October 7, 2017
TIME: 5K Race 9:30 AM & 1 Mile Walk 9:35 AM
LOCATION: Bar Anticipation, 16th Ave Lake Como, NJ
Entry Fee: Pre-Registration by September 22nd = $22, $25 after September 22nd .
Kids Under 12 $10 Pre-Registration and $15 Day of Race – Race Day Registration begins at 8 AM
PRIZES: Top Three Male & Female and Top Three Shillelagh Members.
Also for the top runner in different age groups. Plus prizes for the best/funniest costumes
BBQ to Follow race at BAR A. Free admission for signing up for event.
Food is free for those who sign up for event.
Contact: Bill Ryan, email firstname.lastname@example.org
Register on line at jsrc.org or jerseyrunner.com. Check us out at www.fsosbelmar.org to or you can register or pick up your T-Shirt & Number at the Shillelagh club Friday October 6th from 5 -8 PM as well as Saturday morning day of race starting at 8 AM.
Mail to FSOS Shillelagh 5k, PO Box 627, Belmar, NJ 07719
This form below is for those who do not choose to register online and wish to print it out, write a check for
proper amount (With Out Convenience Fee of $2.50) and send to Shillelagh Club (Address above). If you choose to register online boxes are below.
|Last Name:||First Name:||Age:||Sex:|
|Phone: ( )||Email:|
|Circle Event: 5K Run 1M Walk||Circle Shirt Size: YS YM YL S M L XL XXL|
Shillelagh Member? (circle) YES NO
Registration Fee $_____________
|Optional Additional Donation $_____________|
Waiver of my rights to make claim for illness and/or injury In consideration for my being permitted to participate in the racing event, I hereby waive and relinquish all of my rights to make a claim or file a lawsuit for any injuries and/or Illness that might happen to me during or after this racing event. I fully understand that the Friendly Sons of the Shillelagh of the Jersey Shore is merely sponsoring this racing event as a charity function of the club. I understand the Friendly Sons of the Shillelagh of the Jersey Shore has not made an inspection of the racing course. I further state that I am not relying on any representations of the Friendly Sons of the Shillelagh of the Jersey Shore, either express or implied, as to the nature or quality of the racing course concerning terrain and/or conditions of the course. I understand that participation in a race that is run on municipal streets and or sidewalks has conditions on the ground that includes potholes, depressions and other uneven surfaces and is utilized by other individuals in motor vehicles, on bicycles, pedestrians, etc. that may cause me injury. I hereby release the Friendly Sons of the shillelagh of the Jersey Shore from all anticipated and unanticipated events that might hurt me. I also know that running a road race or walking for any distance is a potentially hazardous activity and that I should not enter and run or walk unless I am medically able and properly trained. I agree to abide by any race official relative to my ability to safely complete the run/walk. I assume all risks associated with running and walking this event including but not limited to falls, contact with other participants, the effect of the weather, including low or high temperatures and/or humidity, traffic and the conditions of the course, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I, myself and anyone entitled to act on my behalf, waive and release the Friendly Sons of the Shillelagh of the Jersey Shore, its Officers, Members and race volunteers, the boroughs of Belmar, Lake Como and Spring Lake and it’s Departments and employees, Jersey Shore Running Club, Bar Anticipation and all sponsors and their representatives, employees and successors from any and all claims and liabilities of any kind arising out of my participation in this event or carelessness of the persons named in this waiver. Further, I grant to all of the forgoing to use any photographs, motion pictures, recordings or any other record of this event for legitimate purposes.
Signature_______________________________________________________________________________Date__________________________Participant signature (or parent/guardian if under 18). Must be a signature here.
Bookings are closed for this event.