Falling Footsteps Application .pdf
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We Will Have:
Glasses to Registrants
Prizes for Age Groups
RSCC Falling Footsteps
The Richfield Springs Community Center cordially invites
you to participate in the annual Falling Footsteps 5K Minimudder. Part of the proceeds will benefit the Youth
Basketball Hoop Fund.
Route 20 Series:
THANK YOU TO OUR SPONSORS!
Name:__________________ Age ______
* Sex: M F (Circle One) (on 9/13/15)
In consideration of acceptance of this
application, I, the undersigned, intending to
be legally bound, hereby, for myself, my
heirs, executors, administrators, and assigns
waive any and all rights and claims for
damages I may have against the Richfield
Springs Community Center, their
representatives and successors for any and
all injuries suffered by me at the races to be
held in Richfield Springs, on Sept. 13, 2015.
I verify that I am physically fit and have
trained sufficiently for the competition.
Please make Checks payable to: “RSCC”
Mail in with Applications to:
Bill Kosina: 1434 Cty Hwy 25 Richfield Springs, NY 13439
Questions: 315-749-3286 firstname.lastname@example.org
The Richfield Springs
Community Center Run
Sept. 13, 2015
TIME: 1:00 – 1:45 on Race Day
PLACE: Richfield Springs Sportsmen’s
Club, Route 25 Richfield Springs
@ 2:00 PM
Pre-registration postmarked on or before (Sept. 5, 2015)
Day of race:
Part of the Route 20 Series
The Richfield Springs
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