PRESENTING THE 14TH ANNUAL
LOUISIANA STATE 4 MILE CHAMPIONSHIP *SPECIAL CHAMPIONSHIP AWARDS* JULY 4, 2013 ** 4 MILES ** CHIP TIMING PRE-REGISTRATION: (until 6/27/13): $4.00 KIDS Half Mile Only ~ no shirt! $20.00 4 Mile Championship Race ~ PLEASE INDICATE SHIRT SIZE BELOW BY MAIL: payable to 15th Street Flyers, 49 Karen Drive, Covington, La. 70433 OR IN PERSON: Varsity Sports Mandeville, 2021 Claiborne Street, Mandeville, La. (985.624.8200) OR ON LINE: https://secure.getmeregistered.com/FourOnThe4th RACE DAY: $4.00 KIDS Half Mile Only ~ no shirt
RACE LIMITED TO 400 ENTRIES DON’T MISS OUT ~ REGISTER EARLY!!
$35.00 4 Mile Championship Race (shirt sizes and availability not guaranteed!) $20.00 No shirt option (race day only) LOCATION: HUBIE GALLAGHER PARK - 15TH AVENUE (3 Blocks off Tyler St) COVINGTON, LA. TIME: 4 MILE - 7:30 AM; KIDS RACE TO FOLLOW
This year’s race will benefit kid’s fitness programs, including the YMCA!
SPECIAL GIFT TO THE FIRST 250 PRE-REGISTERED PARTICIPANTS!! RED, WHITE & BLUE ATTIRE ENCOURAGED! RACE DAY REGISTRATION & RACE NUMBER PICKUP: BEGINS AT 6:30 AM
WE’LL HAVE OVERALL & AGE GROUP AWARDS, GREAT DOOR PRIZES, COOL MUSIC & LOADS OF FUN!
QUESTIONS / DIRECTIONS: (985) 893-3684 OR (504) 460-2991 OR WWW.15THSTREETFLYERS.ORG OR WWW.VARSITYRUNNING.COM
FOLLOWING THE AWARDS CEREMONY: BUDWEISER BIKINI BEER MILE (entries limited) SIGN UP RACE DAY! OVERALL MALE & FEMALE BEER MILE CHAMPION WILL BE CROWNED! BIKINIS ARE RECOMMENDED ********************************************************************************************************************************************** PLEASE COMPLETE THE FOLLOWING INFORMATION FOR EACH PARTICIPANT: (ONE FORM PER PERSON, PLEASE!) Race Number
NAME: _____________________________________________ PHONE: _______________ AGE: ______ ADDRESS: ______________________________________________________________________________________________D.O.B: ______________________ SHIRT SIZE:
_____ _____ _____ _____ ______ (adult sizes only) SEX: S M L XL XXL -please add $1.00 to entry fee
MALE
FEMALE
WALKER: YES
NO
I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all the risks associated with running in this event including but not limited to fall, contact with other participants, the effects of weather, including high heat and/or humidity, traffic and other conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in considerations of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the Parish of St. Tammany, The City of Covington, River Forest Subdivision and the 15th Street Flyers and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all of the forgoing to use any photographs, motion pictures, recordings or any other record of this event for any legitimate purpose. ________________________________________________________ _________________ Signature: by participant or Parent or Guardian if under 18 Date
THANKS FOR COMING OUT!