Law Enforcement Agencies 5K Run/Walk
Saturday, June 24, 2017. Race starts – 6:30am
Poilce Officers’ Club, Hope Road Kingston
ENTRY FORM
RUN
WHEELCHAIR
WALK
SPECIAL ATHLETE
Receipt #
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 Law Enforcement Agencies, Special Olympics Jamaica and all clubs, associati0jons, 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 Law Enforcement Agencies 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. Law Enforcement Agencies and Special Olympics 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:_________________________________________________________________
If you are under the age of 18, you must have a parent or guardian’s signature.
Date:_________/__________/___________
DD
MM
YYYY
Registration Guidelines
Individuals and teams can register at Community Safety and Security Branch, 1 st Floor South Tower NCB Building, 2 Oxford
Road, Kingston 5, Police Officers Club, Hope Road, Kingston or call 1-876-754-0600 for information on other location islandwide.
2. Entry forms can also be downloaded at www.jcf.gov.jm or www.ondirun.com
3. A donation of J$1000 is required per person. Entries are NOT REFUNDABLE or TRANSFERABLE.
4. Complete and sign the Entry Form above and submit along with cash or cheque payment at the Community Safety and Security
Branch, 1st Floor South Tower NCB Building, 2 Oxford Road, Kingston 5 or Police Officers Club, 34 Hope Road, Kingston
(cheques should be made payable to Law Enforcement Torch Run )
5. Registration closes, Friday, June 23, 2017 or upon achieving the event limit, whichever comes first. THERE IS NO RACE
DAY REGISTRATION
6. Race numbers can be collected between Monday June 19 and Friday, June 23, 2017 from 10:30 am to 3:30pm at the Police
Officers Club, 34 Hope Road, Kingston 6. THERE IS NO NUMBER PICK-UP ON RACE DAY
7. Your race number and name of event you entered is to be pinned to the front of your shirt. You must wear the number assigned
to you. Switching of race events is NOT allowed once the race registration is closed.
8. Completed application forms along with proof of payment can be faxed or emailed to the Community Safety and Security
Branch.
Race Information: Tel: Community Safety and Security Branch at 876-754-0600, -876-869-6783, 1-876-866-6588
Fax 1876 9290226
Email: [email protected]
1.
PLEDGE FORM
Law Enforcement Agencies 5K Run/Walk
PLEDGE FORM
I …………………………………………………………………………………….HEREBY PLEDGE $.........................................................
AS CONTRIBUTION TO THE LAW ENFORCMENT TORCH RUN.
PLEASE TICK:
1.
I WILL DELIVER MY PLEDGE
2. PLEDGE MAY BE PICKED UP
If No 2: ADDRESS FOR PICK UP:……………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………………………………….
CONTACT NO………………………………………………………………….
………………………………………………………………
Name:
……………………………………………………………….
Signature