City of Waco, Texas

Police Memorial Run

The Waco Police Association will hold a 5K (3.1 Mile) and 1 Mile Memorial Run on Saturday, May 17 at 8:00 am at the Cameron Park Zoo. Proceeds from this event will help to sponsor activities to recognize officers that go above and beyond the call-of-duty or were killed in the line-of-duty.

Each registrant will receive a souvenir T-shirt, and trophies will be awarded to the top three male and female finishers of the 1 Mile race. In the 5K race, the top three male and female finishers will be awarded in the following age groups: 14 and under, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60 and over. The cost is $12 per person before May 10 and $15 after May 10 and on race day.

For more information, call Sgt. Tim Rhudy at 709-4605 or Det. Anita Johnson at 709-5223.

Registration Form

Instruction: You can type your answers in the fields below. Use the TAB key, not ENTER to travel between the fields. Print out the form, then mail it to: Waco Police Association, PO Box 1023, Waco, Texas, 76703, Attention: Memorial Run. Please include your registration fee. Checks should be made payable to the Waco Police Association

Name:
Address:
City:
State:
Zip Code:

Day Phone:

Sex: Male Female

Age on May 13, 2006:

Check appropriate adult shirt size:
Small Medium Large XL

or youth shirt size

Small Medium Large

Please check race: 5K (3.1 mi.) 1 Mile

Amount enclosed:

Will you be participating as an individual or team?

Individual Team

If you are participating as a team, please list your team name below:

Waiver Statement: Must be signed and submitted with entry

In consideration of the acceptance of this registration entry, I, the undersigned, assume full responsibility for any injury or accident which may occur during my participation in this race, or while I am on the premises of this event. I hereby and release and hold harmless the sponsors, the City of Waco, the Waco Police Association, and its officers and agents and all other persons and entities associate with this event from any and all injury and damage whether it was caused by negligence of the sponsors, promoters or other persons or entities associated with this event, or otherwise. Further, I hereby grant full permission to any or all of the foregoing to use any photographs, videotapes, motion pictures, recordings or any records of this event.

Signature of Participant:

Date:

Signature of Parent or Guardian for Minor:

Date: