Gainspoletti and Associates Ugly Sweater 5k Walk/Run

Gainspoletti and Associates
Ugly Sweater 5k Walk/Run
Thursday, December 4th, 2014 Race Begins at 5:30 p.m.
Registration Location and Start/Finish Location: Downtown Cleveland, MS – Gazebo located on the
Green strip. Day of race registration: 5:00-5:30 .Please come dressed in your ugliest Christmas attire!
Best Dressed will receive a prize.
Kids Area: If you would like to drop off your child the kids area is for ages 3-10 from 5:00-7:00 p.m. Cost
is $5 dollars per child.
Pre-Registration mail entries to Ugly Sweater 5k 805 West Sunflower Road Cleveland, MS 38732 or drop
off at the Gainspoletti and Associates. In order to be guaranteed a goody bag we must receive forms by
November 24th. Questions? Contact Rivers Gainspoletti (662)902-5415 or Brandyn Skeen (662) 843-6090
Registration Options are below. Please check the appropriate package.
________Rudolph Pack: Includes the run/walk and goody bag $35
________SANTA PACK: Includes the run/walk, goody bag, and a ticket to the after party at DELTA MEAT
MARKET. $50
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Children ages 1-10 can eat at the after party for an extra $5.00 per child.
Goody Bag features a GFS Mini Cooler Bag, dri-fit shirt, water bottle, & Cinch Sack!
After Party at Delta Meat Market includes appetizers, 1 free drink, and your name entered in the
raffles. Cash bar after 1 free beer.
Santa will make an appearance at the after party! Please bring your cameras for photos!
After party tickets can be bought at the door for those who just want to attend the party. Ticket is $20.
Raffles are for a Weed eater donated by Wade Inc. valued around $600, Adult Bike donated by New
Belgium Brewing Company valued around $150, and a Children’s Bike donated by Kossman and Powell
valued around $45. Must be present to win.
Make checks payable to Blair E. Batson. The race will benefit Blair E. Batson Children’s Hospital.
Name:________________________________________Dri Fit Adult T-Shirt Size:___________________
AGE:________ DOB:________PHONE NUMBER:______________________ EMAIL:_________________
ADDRESS:___________________________CITY:________________________ STATE:_____ZIP:_______
I hereby certify the following: (1) I am physically fit and have received medical clearance to take part in the Run/Walk and I assume all risk
involved. (2) In consideration for my application to participate in the 5k Run/Walk being accepted, I, on behalf of myself, my heirs and assigns,
and my state, hereby waive and forever discharge the sponsors, organizers, their agents officers, and employees, and any individual associated
with the Run/Walk from any liability for injury, illness, or death suffered and any claims that may accrue in connection with my participation. (3)
I hereby grant Gainspoletti and Associates specific permission to reproduce, publish, circulate, copyright or otherwise use any photographs
and/or videotape of me and/or my family, taken at the Run/Walk, for use by Gainspoletti and Associates.
Signature:______________________________________________________________Date:__________________________________________
(Parent or guardian’s signature if less than 18 years of age)