1.  ………… ……………………………………… …………………… …………………… ……………………… ……………  First Name _______________ Last Name _______________________ E-Mail ________________________________ Mailing Address ______________________________ City ____________________ State ___ Zip ____________ _____-______-___________________________________________________________________ T-shirt YM YL M L XL Phone Date of Birth Age on race day Sex Handicap Y/N Mail Entry Form to: the Dunellen Education Foundation P.O. Box 4106 Dunellen, NJ 08812- Make Checks Payable to The Dunellen Education Foundation, Inc PRE –Registration (Before 9/14) 5K 5K 1Mile Dunellen Dunellen Family Rate Max 4 people @ USATF Walk/Run Student BOE $30 Addt’l person $6 $25 $20 $10 $10 $15 LATE Registration (Day of Race) 5K $30 1 Mile Walk / Run $15 Contact us at: DunellenEducationFoundation@yahoo.com I am unable to participate but wish to support the Dunellen Education Foundation with a donation of $ ________. Release: In consideration of your accepting this entry, I, the undersigned, intending to be legally bound for myself, heirs, executors, and administrators, waive and release any and all claims for damages and injury I may have against The Dunellen Education Foundation, Inc., the Town of Dunellen, their agents, servants, successors, and all other persons or entities involved in the promotion or staging of the Dunellen Run for Education 5K Run, the 1 Mile Fitness Walk / Run race and general participation in the days events. I also give my permission for the use, without fee, of my name and picture in any broadcast, telecast, or print media account of this event for promotional and publicity purposes. I attest and verify that I am physically fit and have trained sufficiently for this event to be held on Saturday, 9/28/2013 in the Town of Dunellen, NJ Signature ___________________________________________________________________________________________________________________________________ Date __________________________________________________ Must be signed for application to be valid. Parental consent & Signature Required (if under 18 yrs. Old) 012 USATF-NJ# _______________________ (Required for New Balance Grand Prix Scoring) Dunellen’s 16 th Annual Run for Education 5K Race & 1 Mile Fitness Walk/Run Rain or Shine Saturday September 28 th at Dunellen High School 411 First Street Dunellen, NJ 08812 Starting Times: 1 Mile 9:30 AM / 5K 10:00 AM Our Mission: The Dunellen Education Foundation supports educational and community-related programs that provide our children with the knowledge and skills to succeed in an increasingly complex and technology driven world. Who We Are: We are a non-profit private organization formed by residents and community partners, to raise funds for new and innovative educational programs for our schools. Our engagement with the community continues year round and volunteers are always welcome. About our Race: The Dunellen Run for Education takes place in historic Dunellen, “The Railroad Town”. We are a tight knit community that enjoys small town living. The race starts and ends at Dunellen’s Middle and High Schools and is attended by families and racing aficionados alike. What people say about us? “Dunellen runs a top race. The course is a flat and fast run through the tree lined streets of Dunellen. With it’s long straightaways, it was the perfect course for me.” Doug Brown – National Masters Champion. What to Expect on Race Day: Costumed designed T-Shirt Race tracked by compuscore.com Refreshments and Watering Stations Music Runners package Race Day Awards Ceremony Special prizes: Mountain Bike for First Place Winner Prizes for Top Overall Male and Female, Age Group and Dunellen Resident category Medals for all participating Youth of the 1 Mile Fitness Walk / Run Packet pickup on 9/27 from 5-8PM at Dunellen High School Cafeteria or on race day from 8-9 AM