Georgia Transplant Portal

Name:

Run Thru The Forest Inaugural 5k

Date:

1/14/2009 to 3/1/2009

Description:

www.eteamz.com/runthrutheforest5k/

Entry Fee: $20.00 pre-registered by 2/26/09.

$25.00 race day 2/28/09

$20.00 Phantom Runner (people who would like the t-shirt but are unable to run)

T-Shirts guaranteed to all pre-registered only. T-shirts will be given out on race day.

Course: Scenic course through Forest Hills neighborhood. Start Time: 8:00 a.m.

Awards: Overall Male/Female, Masters Male/Female, Grand Masters Male/Female, first 3 places in age groups

from 11-14 to 75 & over.

Location: Brinkley Park, 160 Legion Drive, SE, Smyrna, GA

The Purpose: 100% of the profits will be deposited into the Bruce Crandle Kidney Transplant Fundraising Program account with the Georgia Transplant Foundation. The TFP provides dollar-for-dollar match up to $10,000 to help transplant candidates reach fundraising goals and are used primarily for medication costs. GTF provides fund management for reimbursement of pre-and post-transplant related expenses. Go to www.gatransplant.org for more information.

3 ways to register: 1. Online – www.active.com 2. US Mail –4161 Barberry Dr., Roswell, GA 30075 3. Race Day

Make checks payable to: Run Thru The Forest Inaugural 5K

Last Name:_________________________________ First Name: ___________________________

Address: __________________________________ City/State/Zip__________________________

Race (circle one) 5K___ Phantom___ Male ___ Female ____ Date of Birth: ________________

T-Shirt Size (circle one): S M L XL Email: ___________________________________

Waiver: In consideration of acceptance of this entry, I waive any and all claims for liability for myself and my heirs against officials, sponsors, City of Smyrna, and volunteers associated with this event. I am in proper physical condition to participate and give permission for the use of my name and picture in any media or account of this event. (If under 18, parent or guardian must sign).

Signature: _________________________________ Parent/Guardian if under 18: ______________________