July 20, 2012 – NEW CANAAN, CT
KARL Chevrolet is proud to be a founding sponsor of the Annual New Canaan New Balance ‘All Out for Autism’ 5K Race/Walk to benefit SPED*NET. Now in its 4th year, All Out for Autism has grown into a much anticipated community event. This year, the run will take place on August 24, 2012 with the starting line on Main Street in front of the New Canaan New Balance Store. See below for details and an entry form. Thanks in advance for your support of this great cause and event.
When: 8/24/2012 6:00 PM Adult Race/Walk
6:15 PM Kids Race
Where: New Balance of New Canaan, 128 Main St.
Course: 5K through downtown New Canaan for adult course. Kids race is one loop, about ¼ mile
Registration: Online at www.bazusports.com (preferred), in person at New Balance New Canaan 8/20-24, or complete form below and mail or drop off at the New Balance store.
Cost: Before 8/20 $15, 8/20-23 $20, Race day $25
Please make checks payable to SPED*NET New Canaan. Your donation is tax-deductible to the extent permitted by law.
Proceeds contribute to YMCA for programs and events for children with disabilities.
Name:________________________________
Circle: Male / Female Age: ________
Email:________________________________
DOB: ___/_____/_______Phone:_______________
I know that running is a potentially hazardous activity. I should not enter and run unless I am able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risks associated with running this event including but not limited to falls, contact with other participants, the effects of the weather, including high heat and/or humidity, traffic and the conditions of the road all risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting m application, I for myself and anyone entitled to act on my behalf waive and release the race organizers the cities and towns in which this event is held and all sponsors their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings or any other record of this event for any legitimate purpose.
Signature:______________________________
Date:_________________
Complete this Registration form and return to:
New Balance New Canaan
128 Main St.
New Canaan, CT 06840
Phone: 203.801.0050
email questions to: nbnewcanaan@yahoo.com
for more information, visit: www.alloutforautism.org
