ENTRY FORM
Saturday, May 13, 2017 • Emancipation Park
Race Start - 6:00am
Make A Difference!
Regular
Entry Type:
Race Event:
Premium
Last
Name
RUN
Receipt No.:
WALK
First
Name
Date of Birth
(Year)
(Month)
Contact
Number
Gender
Age
(Day)
M.I.
(Race Day)
(M/F)
Email
Individual
Entry Type
Team
Name
EMERGENCY CONTACT:
T-Shirt Size Premium package only (see below).
Last Name
Small
Medium
Large
Extra Large
First Name
Contact Number
Relationship
Indemnity (All Participants must sign this Waiver):
In consideration for me being permitted to participate as an entrant or competitor in this race, I, my heirs, executors and administrators hereby release, waive and keep indemnified
Running Events Limited, Food For The Poor Jamaica and all clubs, associations, companies, sponsors, participants, competitors, entrants, and all of their respective agents and servants
from and against all actions, claims, costs, expenses, demands in respect of death, injury, loss or damage to my person or property howsoever caused by arising out of my permission
to attend at, or in any way participate during or subsequent to the said Food For The Poor 5K Run/Walk whether as spectator, participant, or competitor, entrant or otherwise, notwithstanding that the parties above-mentioned their servants and/or agents may have contributed to the aforesaid injury, death or loss. Further, the participant grants full permission to any or all
of the releases to use any photographs, video tapes, motion pictures, recordings, and any other record of this event for any legitimate purpose. Food For The Poor Jamaica retains the
property in all photographs, video and audio material arising from the event and reserves the right to use all such images and sound as it sees fit for legitimate purposes without the
participant’s consent. If the participant is younger than 18 years old, the parent or guardian should accept the Indemnity.
Signature:
Date:
If you are under the age of 18, you must have a parent or guardian’s signature.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Since its establishment in 1983, Food For The Poor has been improving the health, economic, social and spiritual conditions of the poor in
Jamaica. They have supported programmes in housing, food, medical, water, sanitation, education, agriculture, outreach and microenterprise. In continuing their fundraising efforts, Food For The Poor will host its annual 5K Run/Walk on Saturday, May 13, 2017 to raise
funds to build homes for the less fortunate, and to increase awareness for their various areas of ministry.
•
Registration
Guidelines:
1. Entries will not be processed without payment of race entry fees:
• Regular: Individuals - $1,200 per person on/before Friday, April 21 and $1,500 after, up to the registration deadline of Friday,
April 28, 2017. Teams with 20 or more persons - $1,000 per person.
• Premium: $2,500 per person. Includes a souvenir T-shirt, light breakfast and delivery of race bib within the corporate area.
Package is available up to Friday, April 21.
Entries are neither refundable nor transferable, and name changes are not allowed.
2. Individuals and teams can register and pay online using a Visa debit or any credit card at www.RunningEventsJa.com.
3. Or, pay at ANY Paymaster location islandwide, using the following information: vendor - Food For The Poor Jamaica and
account no.: 9845005. Then, submit your completed entry form and payment receipt to Food For The Poor, Ellerslie Pen, Spanish Town or at any of the following Paymaster locations, up to Friday, April 28: John R. Wong, 1-5 Tobago Avenue, Kingston 5;
Lee's Food Fair, 86 Red Hills Road, Kingston 20; Loshusan Supermarket, 29 East Kings House Road, Kingston 6; Super Valu,
56 Mannings Hill Road, Kingston 8; Shopper's Fair, Shop 3C, Portmore Mall, Portmore; DHL, 54 Duke Street, Kingston.
4. Registration closes Friday, April 28, 2017 or upon achieving the event limit, whichever comes first. THERE IS NO RACE DAY
REGISTRATION.
5. Race packets must be collected before race day on Thursday and Friday, May 11 - 12 at Emancipation Park, New Kingston
between 11:00am to 5:00pm. THERE IS NO NUMBER PICK-UP ON RACE DAY.
Race Information
Food For The Poor 5K Secretariat
Tel.: (876) 984- 5005 / 564-2444 / 486-3002
Email: [email protected] • Website: www.foodforthepoorja.org