ENTRY FORM

Saturday, May 9, 2015 Emancipation Park

Race Start - 6:30am

Donate towards building a home!

WALK

RUN
Last
Name

Receipt No.:

First
Name

Date of Birth
(Year)

(Month)

Contact
Number

Gender

Age
(Day)

M.I.

(Race Day)

(M/F)

Email
Individual

Entry Type

Team

Name

EMERGENCY CONTACT:

Last Name

First Name

Contact Number

Relationship

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
Running Events Limited, Food for the Poor Jamaica and all clubs, associations, 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 Food for the Poor 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. Food for the Poor 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
participants consent. If the participant is younger than 18 years old, the parent or guardian should accept the Indemnity.

Signature:

Date:
If you are under the age of 18, you must have a parent or guardians signature.

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Since its establishment in 1983, Food For The Poor has been improving the health, economic, social and spiritual conditions of the poor in
Jamaica. They have supported programmes in housing, food, medical, water, sanitation, education, agriculture, outreach and microenterprise. In continuing their fundraising efforts, Food For The Poor will host its inaugural 5K Walk/Run on Saturday, May 9, 2015 to raise
funds, and to increase awareness for their various areas of ministry.

Registration Guidelines:
1. Individuals and teams can register and pay online using a credit card at www.RunningEventsJa.com.
2. Entry Fees: Individuals and teams of less than 50 persons - $1,000 per person. Teams of 50 or more persons - $900 per person.
Entries are neither refundable nor transferable, and name changes are not allowed.
3. Complete and sign the Entry Form above and submit along with payment at select Food For The Poor distribution locations:
Stella Maris Church, 62 Shortwood Road, Kingston 8; St. Richard's Church, 126 Red Hills Road, Kingston 19; Sts. Peter & Paul
Church, 120 Old Hope Road, Kingston 6; Chez Maria, 7 Hillcrest Avenue, Kingston 6; Food For The Poor, Ellerslie Pen, Spanish
Town, St. Catherine.
4. Registration closes Friday, April 24, 2015 or upon achieving the event limit, whichever comes first. THERE IS NO RACE DAY
REGISTRATION.
5. Race packets can be collected at PROComm, 6 Kingsway, Kingston 10 on Wednesday - Friday, May 6 - 8 from 11:00am to
5:00pm. THERE IS NO NUMBER PICK-UP ON RACE DAY.
6. Your bib number will be labelled with your name and marked for the event you entered. The bib is to be pinned to the front of
your shirt. You must wear the bib number assigned to you. Switching of race events is NOT allowed once race registration is
closed. Entrants in the Run event can Run and Walk. However, the Walk race is for Walkers Only.
Race Information
Food For The Poor 5K Secretariat
Tel.: (876) (876) 907-3664 / 548-3487 / 437-7271
Email: secretariat@foodforthepoorja.org Website: www.foodforthepoorja.org