Homeless Initiative 5k & 7 Mile Bike Ride
Website: www.tiogahomeless.org
E-Mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
WHEN: July 8, 2023
Register by June 30th at www.runsignup.com
WHERE: Darling Run Pine Creek Rail Trail
TIME: Registration from 8:30 to 9 AM. Run begins at 9 AM.
WHY: Benefiting the Tioga County Homeless Initiative
ENTRY FEE: $20 by June 30th. $25 after June 30th and day of event.
(Checks made payable to Tioga County Homeless Initiative (TCHI))
COURSE: The course is an out & back trail on a flat, hard-packed gravel surface, 5K participants will travel 1.5 miles and turn around and head back. Participants biking. Will travel 3.5 miles and turn around and head back.
AWARDS: Medals to the Overall Male & Female 5K finishers. Medals to the 1,2,3rd place 5k finishers in age Divisions. Finisher Ribbons for bike participant
AGE GROUPS: 12 Under. 13-17, 18-23, 24-29, 30-39. 40-49, 50-59, 60+
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ENTRY FORM Mail to: Tioga County Homeless Initiative 2580 Charleston Road, Mansfield, Pa 16933
Name:__________________________________________________________
Address:______________________________________________________________
Phone:_____________________ Age:______ Gender:_____ Hike ____ or Bike _____
E-mail: __________________________________
In consideration of the opportunity to enter this event, I, my heirs, executors, administrators, and assigns, hereby, waive, release and forever discharge the Commonwealth of Pennsylvania, Tioga County Homeless Initiative and its associated organizers, committee members, and any other persons connected with this event in any capacity, for any claims and demands as a result of damages arising from any injuries suffered during the event, including those attributed to weather conditions and course conditions. I hereby grant full permission to the event organizers, committee(s), volunteers, and any other involved parties of the foregoing to use photographs, videotapes, motion pictures, or other record of this event, including name, likeness and/or voice for legitimate purpose. I have read, understood, and agree to the Liability Waiver on this form. Participants and spectators fill out and sign a form to participate (sign-up sheet). This form contains a clause that states that they will release and hold harmless the Tioga County Homeless Initiative and the Commonwealth of Pennsylvania from any and all liability arising from participation in the activity. Tioga County Homeless Initiative will be carrying activity insurance for the event. All participants and spectators will receive a safety briefing prior to the event where any and all risk are conveyed to participants and spectators. At this briefing, children or minors will be informed of these risks in the presence of their parents of guardians, and parents or guardians will need to sign the release mentioned above for their children or minors in their care.
_______________________ _________________________ __________
Signature of Participant Signature of Parent Date
(If under 18)