S
South Fayette
outh F
ayette T
Glow Run
5k Run & 1 Mile Run/Walk n Saturday, June 7, 2014
Registration begins @ 6:30 pm
1 Mile Run/Walk @ 8:00 p.m. • 5k Race @ 9:00 pm
South Fayette Stadium
All Proceeds Benefit Children’s Hospital of Pittsburgh Foundation
Name______________________________E-mail Address___________________
INFORMATION ON THIS FORM MUST BE COMPLETED IN FULL!
Standard Package
Standard + Glow Package
Includes:
Includes:
$25
$30
5K or Mile
5K or Mile (please circle one)*
Everything in Standard
Package Plus:
(please circle one)*
• Neon “Glow Run” T-Shirt
• “Glow Run” Draw String Bag
• 1 glow-in-the-dark Necklace
• “Glow Run” Ribbon
• Running Bib
Unforgettable glow-in-the-dark
experience!
• 2 glow-in-the-dark bracelets
• 1 pair of glow-in-the-dark glasses
• 1 additional multicolored glo- in-
the-dark necklace
• “Glow Run” Water Bottle
PERMISSION AND ASSUMPTION OF RISK:
I, the undersigned below, in consideration of my and/or my
child’s participation in the above referenced event, and any
related activities (“Event”), consent to the participation of the
Participant named below, and freely and knowingly assume
on my own and/or my child’s behalf all risks incidental to
such participation, including the risk of physical injury. In
addition, I hereby release the South Fayette Township and
School District from any and all liabilities associated with
such participation in the Event.
BASED ON THE ABOVE TERMS, I CONSENT TO PARTICIPATON
IN THE EVENT FOR THE PARTICIPANT LISTED BELOW.
Participant Name___________________________________
Street Address_____________________________________
City_______________________
State ______________ Zip Code_______________________
Phone Number: ____________________________________
*Space is Limited
E-mail____________________________________________
Come and join us for two fun and exciting races with food, games, raffles,
face painting, music, and more glow-in-the dark than you can imagine!
SHIRT SIZE (please circle one)*
Youth: S
M
L
Date of Birth_______________________________________
Emergency Contact
Name & Relation____________________________________
3XL
Emergency Contact Number__________________________
If you do not wish to run but would like to make a contribution to our cause, tax deductable
monetary donations or Chinese auction items can be sent to the below address.
Signature________________________________ Date_____
Adult: S
M
L
XL
ALL FORMS DUE BY MAY 12th, 2014
in order to receive items listed above
2XL
This form and cash or checks payable to South Fayette School District must
be submitted to any SF School Office or mail to SF High School, Attn: Felix
Yerace, 3640 Old Oakdale Road, McDonald, PA 15057
Please e-mail sfglowrun@gmail.com with questions!
Parent Signature: __________________________
(If Participant is under 18. If Participant is 18 or over but still enrolled in
high school. the parent must also still sign)
Date______________________________________________
South Fayette | Summer 2014 | icmags.com 61
ownship SC HOOL D IS T RIC T NE WS
South Fayette Student Government