My Big Race
5K Run/Walk
Sunday, January 8, 2014
11:00 am

Race Location: Pittston Area High School.  Registration begins at 9am in the School lobby

Directions: Stout Street, Yatesville. Coming from South on 315 turn left at the St. Josephs Oblates. (From North on 315 turn right). Turn left at Y and up hill about ¼ mile. FROM North on 315 turn right

Course Description: Slightly hilly. Downhill start through Yatesville, crossing James Musto bypass, down Swallow Street, onto Main and up Stout Street, finishing with one lap around high school.

Awards: Top three male and female receive trophy. Top master and Clydesdale receive a trophy.  Top three in 5 year age group will receive medals

Course Records: Gunther Fromm 14:41 Sister Fromm 16:21

Proceeds: Benefit the upcoming Area Special Olympics events.

Entry Cost information: $15 with T-shirt {8 without}, $16 after December 20, 2013. Cost of pre-registration and cut off date for discount, Cost of day of the race.
Guaranteed T-shirts to all full price paid participants. If shirts run out, you will be mailed.

Other Information: Results by Insta-Results and timing by the Wyoming Valley Striders.

Make Checks to: Area Special Olympics. And mail to: 99 Your St. Your Town, PA. 18640

Contact:  John Doe 555-1234, fax 555-1235, email-

Website: Race forms are also available online at, Results will be posted at same.

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Name_____________________________________________ Sex____Age______
Address ____________________________________________________________
City, State Zip ________________________________________________________
Phone ___________________________    E-mail ___________________________
SHIRT SIZE (circle One)       SM         M        L       XL       NONE
Name of affliation of Club or Team _______________________________________

In consideration of your accepting this entry,I, the below signed, intending to be legally bound, for myself, my heirs,my executors and administrators, waive and release and any all rights and claims for damages I may have against the race, and sponsors and their representatives, successors and assigns for any and all injuries suffered by me in said event. I attest that I will participate in this event as a footrace, that I am physically fit and sufficiently trained for the completion of this event. Furthermore, I hereby grant full permission to use my name and likeliness, as well as any photographs and any record of this event in which I may appear for any legitimate purpose, including advertising and promotion.


Parent or Guardian if under 18_____________________________________

No refunds will be issued for any reason