RUN FOR THE HILL SATURDAY NOVEMBER 2ND 2013 10:00AM

4TH Annual Hilltown Christmas 5K RUN FOR THE HILL Entry Fee $20.00 by 10/29/13or $25.00 Race day No Refunds FREE Tee Shirt for the first 150 participants Drop boxes will be available for those wishing to donate a new unwrapped toy
CORNELL COOPERATIVE EXTENTION MARTIN RD VOORHEESVILLE, NY 12186 Registration & Parking will be at the Cornell Cooperative Extension building If addition parking is necessary, please use the Voorheesville Middle School parking lot south/west of Martin Rd. All proceeds go directly to the Albany County Sheriffs Hilltown Christmas program, The Hilltown Christmas program has been assisting families for the past 21 years, Last season alone we assisted more than 200 Albany County families with Food, Toys, Clothing and a little Holiday cheer. If you can not attend and would like to make a donation please make check payable to ACSD Hilltown Christmas 390 New Salem Rd. Voorheesville, NY 12186 or check www.albanycountysheriff.com for drop box locations.

Prizes will be given to the top male and female in the following age groups 14 & under 15-19 20-29 30-39 4049 50-59 60-69 70+ A prize will be awarded to the top male and top female in the public safety category

GOOD WARM UP FOR STACKADE-A-THON

LAST NAME ____________________________

FIRST NAME __________________________

ADDRESS __________________________________________________________________________ CITY ______________________________ EMAIL _____________________________ SHIRT SIZE _____ XL _____ LG STATE _________ AGE _________ ZIP CODE ______________ GENDER _________________

_____ MD

_____ SM * Sizes are NOT guaranteed *

PUBLIC SAFETY PERSONNEL ____ YES ____ NO AGENCY _________________________ MAKE CHECKS PAYABLE TO: ALBANY COUNTY SHERIFFS HILLTOWN CHRISTMAS MAIL APPLICATION & CHECK TO : 58 Verda Avenue, Box A, Clarksville, N.Y. 12041
Participant waiver: by signing below I hereby release and waive any and all claims for damages I may have against the Albany County Sheriffs Office, Town of New Scotland, Village of Voorheesville, Cornell Cooperative Extension, Voorheesville High School and the volunteers and organizers and sponsors affiliated with this event, for any injuries I any suffer in conjunction with this race. I also certify that I am in good physical condition and have trained for this race. Further, I hereby grant all permission to any and all the foregoing to use photographs, videotapes, motion pictures recordings and/or any other record of this event for any purpose. SIGNATURE ________________________________________________ DATE ____________________________