The 29th Annual Dr. William Perkins Memorial Events Saturday, July 19, 2014 Wayne County Fairgrounds Website: Perkinsrun.com Sponsored by Wayne Memorial Health System, Inc. Honesdale’s Friends of Track & Field and Cross Country Wayne County Commissioners 5K Run 8:30 a.m. Flat and Fast -Start and finish at Wayne County Fairgrounds, one mile north of Honesdale, Rt. 191. Individual Awards (No duplications) Male and Female 0-12 40-44 13-15 45-49 16-18 50-54 19-24 55-59 25-29 60-64 30-34 65-69 35-39 70+ 1st Place Overall Male & Female Receive Award. 5K Age Groups: Awards to 1st, 2nd, 3rd Place. 1st Place Male and Female WMHS Employee Receive Trophy. *High School Challenge* Sponsored by Brian T. Kelly C.P.A. RE/MAX Wayne Pioneer Construction Co. Inc. B & B Chrysler Dodge Jeep Ram Cash Award Donated to High School Affiliated Booster/Parent Clubs $200 Top Men’s Race team (5 runners per team) $200 Top Women’s Race team (5 runners per team) $200 to the team with the most participants 5K Wayne Memorial Fitness Walk 8:30 a.m. We welcome walkers of all ages. Challenge yourself and the clock in this noncompetitive event. Separate Runs for Men and Women (if needed) Individual Awards Male and Female 0-5 19-29 6-8 30-39 9-12 40-49 13-15 50-59 16-18 60-69 70+ 1st Place Male and Female Overall Receive Awards. 1st Place in Each Age Group Receives Award. Quarter Mile Fun Run 9:45 a.m. On the Fairgrounds Track. Ribbons to finishers. Return this section with Entry Fee by July 12, 2014 (PLEASE PRINT) Make checks payable to: Friends One Mile Run 9:30 a.m. Two laps around track Adult Shirt Size: XS S M L XLG (Circle One) of Track & Field & Cross Country Send to: Tammy Jensen, 315 Elizabeth St. Hawley, PA 18428 570-352-6100 email: [email protected] Please check events you wish to enter below: _____5K Run (3.1 miles) $18; (Post entry $20) _____One Mile $10: (Post entry $12) _____Quarter Mile (Free) _____5K Fitness Walk $12 (Post entry $15) Family Discount: Each member must use a separate form of a family entered after the first three (3), Pre-entry -- $5 each additional family member Post-entry -- $8 each additional family member Name________________________________________Sex_______Age (as of 7/19/14)____________________ Address___________________________________________________Phone____________________________ City_________________________________________State______Zip_________________________________ In consideration of the acceptance of my entry, I, intending to be legally bound, do hereby waive, release and discharge any and all claims which I may have or which may hereafter accrue against any and all sponsors while participating or while traveling to and from the event. Signature_______________________________________________(Signature of parent if runner is under 18) High School Team___________________________________________Check if WMH Employee______