Book It! 5K Run/Walk & 1 Mile Fun Walk Registration
Part of the Hopkins County Literacy Celebration

Event Date: March 23, 2019
Pre-registration: Tuesday, March 15th to guarantee T-shirt
On Site Registration Opens: 8:00 am  Race Starts: 9:00 am
Event Location: Baptist Health Fitness Formula- Madisonville, KY

Make checks payable to: Literacy Celebration Committee
Mail to: c/o Peggy Stirsman, 111 Cottonwood Dr., Madisonville, KY 42431
Contacts: Peggy Stirsman (270) 836-3766 or Lori Harrison (270) 825-6000
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Name *
Address *
Email *
Phone Number *
School *
An award will be presented to the school with the most participants.
Race Registration Information *
Required
T-shirt Information (included with registration)
Small
Medium
Large
X-Large (Adult sizes only)
2X-Large (Adult sizes only)
Adult Shirt Size:
Youth Shirt Size:
Additional T-shirts $8 each
Small
Medium
Large
X-Large (Adult sizes only)
2X-Large (Adult sizes only)
Adult Shirt Size:
Youth Shirt Size:
5K Run- Age Division
1st place awards will be given for male and female in each age division.  1st place overall awards will be given in the male and female divisions.
6 and Under
7-11
12-16
17-24
25-34
35-44
45-54
55-64
65 and Over
Male
Female
Release: Signature (Parent or Guardian required if under 18) *
In consideration of my participation in the Book It! 5K and Fun Walk, I do hereby agree to hold free from any and all liability Pennyrile Reading Council, Hopkins County Schools, event sponsors and/or their volunteers and employees. I do hereby waive all rights to claims for all injuries or damages incurred. I do declare that I am physically sound, having medical approval to participate in the Book It! 5K/Fun Walk. I further grant permission to the sponsors and organizers to use my photographs, videotapes, and other recordings of the event for any publicity.
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I understand that I am responsible to pay my race entry fee: *
Make checks payable to Pennyrile Reading Council.  Mail checks to: LITERACY CELEBRATION COMMITTEE c/o Peggy Stirsman 111 Cottonwood Dr., Madisonville, KY 42431
Required
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