5K MEMORIAL RUN/WALK VENEFIT

5K MEMORIAL RUN/WALK
JUNE 12, 2021
BENEFITING
THE FAMILIES of CONCHO COUNTY SHERIFF’S OFFICE
SGT. STEPHEN JONES
&
DEPUTY SAMUEL LEONARD
LOCATION OF RACE: CHAMBER OFFICE– 100 E. San Saba, Menard 76859
Questions: Call Cherry Swindall @ 325-456-3950 or Jessica Rayburn @ 432-559-6488
Entry Fee: $15.00 per person, $35.00 per family of 3. Pre-Registration available until June 11th, 2021 by 4 p.m.
On-site registration and number pickup: 7:00 a.m.—7:20 a.m. Race Begins @ 7:30 a.m.
Make check(s) payable to:
Eden State Bank
Proceeds will be divided between the families.

OFFICIAL ENTRY FORM:
FIRST NAME:____________________________LAST NAME:________________________________ GENDER:____________
MAILING ADDRESS:_________________________________CITY:___________________STATE___________ ZIP:_________
COUNTY:_________________________ EMAIL:__________________________________
RUN___________WALK___________ CIRCLE AGE CATEGORY: YOUTH HIGH SCHOOL ADULT FAMILY

Waiver: In consideration of the acceptance of this entry, I for myself, executors, and assignees, do hereby release and discharge the Land Owner, City of Menard, Menard Chamber of Commerce, Race Directors and all sponsors, workers, officials, and volunteers from any claim whatsoever arising from my participation in this event. I understand the risks for such an event. I attest and verify that I am sufficiently physically fit for this run/walk.
Entrant’s Signature:___________________________________________________ Date:______________________________
Parent’s Signature (if under 18): _________________________________________ Date:______________________________

Dianne Schuder

Eden Chamber of Commerce Secretary

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