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Saturday June 9th 7:30 a.m.
6th Annual Honor & Duty 5K Race and Fun Walk
to End Veteran Homelessness
Benefiting the Next Step Homelessness Services
Date: Saturday, June 9th, 2018 Start Time: 7:30 a.m. Where: Ft. Chaffee (Darby Ave. & Ellis).
Name: _____________________ Age_____ Gender M F Email ___________________
Street Address ___________________ City ______________State ________ Zip ________ Phone Number ________________
Entry Fee: Preregistration Ends May 31st, 2018 ____ 5K ($30) Shirt Size (Circle One) S M L XL XXL
Those who register by May 31st guaranteed a Tshirt. After PreRegistration and Day of Race ____ 5k ($35)
Make Checks Payable to: The Next Step Homeless Services
Early CheckIn Friday, June 8th, 10:00 a.m 6:00 p.m. at Fort Smith Adult Education Center, 501 S. 20th St.
CheckIn Day of Race: Begins at 6:30am
Medals will be given to overall 1st, 2nd, 3rd and in each age group and 1st, 2nd, and 3rd overall male and female.
Door Prize Drawings will be for participants of 5K
Waiver and Release of Claims: I understand that my consent to these provisions is given in consideration of the acceptance of this registration and for being permitted to participate in this event. I am a voluntary participant in this event, and in good physical condition. I know that this event is a potentially hazardous activity and I hereby assume full and complete responsibility for injury or accident which may occur during my participation in this event or while on the premises of this event, and I hereby release and hold harmless and covenant not to file suit against The Next Step Homelessness Services, and any affiliated individuals, Honor and Duty 5k, ArkansasRunner.com, any race sponsors and their agents and employees, and all other persons or entities associated with this event (the “Releasees”) from any loss, liability or claims I may have arising out of my participation in this event, including personal injury or damage suffered by me or others, whether the same be caused by fall, contact with participants, conditions of the course, negligence of the Releasees or otherwise. If I do not follow all the rules of this event, I understand that I may be removed from the competition.
Mail Form to: The Next Step Homeless Services, 123 N. 6th St., Suite 200, Fort Smith, AR 72901 Email: Larry Favalora @ firstname.lastname@example.org or Kim Wohlford at email@example.com.
For more information, go to TheNextStepfs.org A UNITED WAY AND CDBG AGENCY
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