1. The Antietam National Battlefield is the place to be on August 1, 2015! Come join us on a warm summer morning to help support a wonderful cause: CHARGE Syndrome Foundation! This Chip- Timed 5K/Walk/Run will take place through a portion of the historic Battlefield with ALL proceeds generated from this event going directly to CHARGE! Visit tylertrot.org to learn more about our event (including course maps) or to Register Online!! Saturday, August 1, 2015 7:00 a.m. – Registration 8:45 a.m. – Kids Fun Run 9:00 a.m. – 5K Walk/Run Saturday, August 1, 2015 7:00 a.m. – Registration 8:45 a.m. – Kids Fun Run 9:00 a.m. – 5K Walk/Run Location: Antietam National Battlefield, 5831 Dunker Church Road, Sharpsburg, MD 21782 www.nps.gov/ANTIwww.nps.gov/ANTI Amenities: Participants registered by July 18 (including the Kid Fun Run) guaranteed race day T-Shirts! Refreshments for ALL! Numerous items to be raffled off as well! Awards: Overall Male and Female in the following age categories: Under 18; 18-30; 31-40; 41-50; 51-60 and 60 and above Entry Fee: $30 pre-registered (before July 18), $35 after July 18 and on race day. Kid Fun Run is $10 to all under the age of 10 Packet Pick-Up:July 31 st (Friday) 6pm-8pm at the gazebo located at the entrance of Westfield Community Development on Rockland Drive (just off of Sharpsburg Pike/ Rt. 65) Race Day, August 1 st (Saturday) 7 am-8:45 am at the Antietam Battlefield Send entry forms, CHARGE Syndrome Foundation fees and make 21448 Ruble Road checks payable to: Boonsboro, Maryland 21713 Please visit www.chargesyndrome.org to learn more about thiswww.chargesyndrome.org perplexing syndrome or contact Kristen Matthew by emailing tylertrot@gmail.comtylertrot@gmail.com with questions or concerns! Special Features: Chip Timing! Real Time Results! Your time texted automatically to your Cell Phone!! Brought to you by SpectaSport LLC Tyler Trot 5K Walk and Run “CHARGE Ahead!” Registration Form PRINT Name: _______________________________________________Age (race day): _______ Gender: _______ Address: _______________________________________________Emergency Contact: ______________________ Email: _______________________________________________ Emergency Contact #: ______________________ Phone #: _______________ Race (Circle): 5K Kids Fun Run T-Shirt Size (Circle): XS S M L XL (Adult or Child) I give permission to have my finish time texted to my cell phone: Please initial________, Cell phone carrier __________,Cell # ______________ I hereby certify that I am adequately fit to run and/or walk in the Tyler Trot 5K. In consideration or the acceptance of this entry, I, the undersigned, for myself, my personal representative, beneficiaries, and heirs, knowingly waive, release, and discharge any and all rights and claims which I have or may have hereafter accrue to me or my estate against the Antietam National Battlefield and/or any other sponsors, organizers and volunteers and assigns for any and all injuries or death suffered by me in this event. I will also allow my picture to be used in publication as a result of the race. Signature:____________________________________ Date:_____________________________ (A parent or legal guardian must sign for all participants under the age of 18) This event is dedicated to the loving memory of Tyler James Matthew (2004-2006) Beloved son, grandchild, nephew… our “Silent Soldier”