Register by Sept. 1 to ensure T-ShirtT-Shirt Size: Youth/Adult S M L XL XXL

3rd Annual

5K Run - Tribal Trot& Little Indian Run

• Saturday, September 15thRegister 7:30 a.m.

• Run /Walk Starts 8:00 a.m. atthe Jackson High School

• Entry Fee -Adults $20 | Students $10

• Dry-Wick Shirts guaranteedto Pre-registered• Breakfast following 5K• Virtual Runner?

3rd Annual 5K Run - Tribal TrotLittle Indian Run • Ages 7-12

Each Participant must complete a registration form

SIGNATURE__________________________DATE___________________Please return to: Jackson R-2 Board Office, 614 E. Adams St. Jackson, MO 63755

Waiver: In consideration of foregoing, I myself, executors, administrators, and assigns, do hereby discharge Jackson R-2 Foundation and allsponsors from any and all claims of damage, actions, and causes whatsoever, in any manner arising or growing out of my participation.

M/DD/YYYY

5K Run - 5K Tribal TrotLittle Indian Run

Make Checks payable to: Jackson R-2 SchoolDistrict Foundation

Do you have other plans on Sept. 15th? Would you prefersleeping in or doing something else rather than gettingup early to run or walk? You can do virtually anythingelse you want and still support the Jackson R-2 SchoolFoundation!!! You can have the best of both worlds! This levelor participation accommodates your busy schedule. VirtualRunner participants will receive a T-Shirt.

Saturday, September 15, 2012

Saturday, September 15, 2012

5KWalk VirtualRunner5K Run

Little Indian Run$20 -

$10 -

Name Date of Birth Male / FemaleAddress E-MailCity/State Phone

5K Run Age Groups Men &Women:13-19, 20-29, 30-39, 40-49, 50-59, 60 & over

FitnessWalk:OPEN to all, Non-Competitive

Little Indian Run:Ages 7-12