8TH ANNUAL MICHAEL MICHELINI 5K FOR LLS


                                                                                 8TH ANNUAL MICHAEL MICHELINI 5K RACE

                                                                   All Proceeds to Benefit the Leukemia and Lymphoma Society
                                                                                                  WIN * ROCK * CURE
 

Date:                      Sunday, October 16, 2016 – 1:00 PM SHARP

Distance                 5K (3.1 miles)                                                                

Location/Course:    Start: Islip Town Hall, corner of South Bay Avenue and Montauk Hwy to Islip Town Beach, and back to Islip Town Hall area.  Straight and flat, just like we like em’.

Entry Fee:              $30 pre-registration or $40 day-of-race registration

Deadline:                Pre-registration entries must be postmarked on or before 10/14/14

                                
Only Pre-registered participants are guaranteed race t-shirts!!!

Check-In & Day of  Race Registration:  11:00AM – 12:30 PM on race day in front of Islip Town Hall   

Timing:                   START2FINISH                 

Awards:      Presented to the first overall male and female finishers; first male and female Islip Village residents; and the top 3 male and female runners in the following age categories:  14 and under, 15-19, 20-24, 25-29, 30-34, 35–39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70-74, and 75+

Directions:    Southern State Pkwy to Route 111 South to Rte. 27A (Montauk Highway).  Make a right at the traffic light and       Registration/Sign-in is 100 yards down on the right.  

Info & Questions:    kedwards@cancersucks5K.com

Online Reg:    www.active.com (search word: Michelini)

LIVE MUSIC BEFORE AND AFTER THE RACE WITH BLIND SQUIRRELS

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8th Annual Michael Michelini 5K Race Application

NAME_____________________________________________________   AGE ___  SEX ___

ADDRESS____________________________________________________________________

TOWN _____________________________________ STATE _________ ZIP ____________

PHONE _____________________________  EMAIL_________________________________

              T- shirt size (Circle one):              Medium              Large           Ex-Large

 

Make checks payable to:  The Leukemia and Lymphoma Society 

Mail checks to                Kevin Edwards
                                        131 Brightside Avenue

                                        Central Islip, NY11722

WAIVER: In consideration of the acceptance of my entry, I hereby, for myself, my heirs, executors and administrators, waive, release and forever discharge any and all rights and claims for damages which I may have or which may hereafter accrue to me while traveling to and from or participation in the Michael Michelini “ Cancer Sucks” 5K, against the Town of Islip, the County of Suffolk, the State of New York, Start2Finish and their respective offices, agents, representatives or successors, along with any sponsors, supporters and volunteers of said event, as a result of my participation in said run.  I hereby attest and verify that I have full knowledge of the risk involved in participating in this event and that I am physically fit and sufficiently trained to participate.  I have read the above statement, and I understand it and my signature confirms its full acceptance.

 

                                             _________________________               __________________________________________
                                                              Date                                      Signature (or Parent/Guardian Signature if under 18)