Saturday November 4, 2017

9:00 a.m.texas High School track

4001 Summerhill road ~ texarkana, texas 75503For eaSy aNd SeCure

oNLINe reGIStratIoN, Go toSignMeUp.com/120881

oNe reGIStratIoN Form IS reQuIred Per PartICIPaNt Name: _________________________________________________________________________________________

Address:_______________________________________ City:_________________ State:________ Zip: __________

Email Address: _______________________________________ Phone: _____________________________________

Emergency Contact: ___________________________________ Phone: _____________________________________

SeLeCt a CateGory: ___ 9:00 a.M. - Dash For Cash 5K Run/Walk .......$25.00 ___ 10:00 a.M. - Family Fun Run/Walk .................$15.00 ___ TISD Student .....................................................$15.00 ___ MaKe a DonaTIon - “Too Tired To Trot” ....$20.00T-shirts will be provided to all pre-registered participants. Those registering within a week of the event will receive shirts on a first come, first served basis. Select your size:

(Circle one) Youth: S M L adult: S M L XL 2XL 3XL

PACKET PICK-UP will take place on THURSDAY, noveMbeR 2, 2017 from 11:00 a.m. – 1:00 p.m. and 4:00 – 6:00 p.m. at the TISD Administration Building, 4241 Summerhill Road, Texarkana, Texas 75503.

Otherwise, race packets can be picked up the morning of the event beginning at 8:00 a.m.

WaIver aNd reLeaSeI understand that participating in the Texas High School “Dash For Cash” 5K Run/Walk or the Family Fun Run/Walk are potentially dangerous activities. I should not enter and run or walk 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 compete in this event. I assume all risk associated with participating in this event, including, but not limited to, falls, contact with another participant in the event, the effects of weather, including high heat and/or humidity, dehydration, hypothermia, flora and fauna encounters, traffic and the conditions of the course; all such risks being known and appreciated by me. Having read this release and waiver and knowing these facts and in consideration of your accepting my entry, I, for my behalf, waive and release and agree to indemnify and hold harmless Texas Independent School District, Texas High School, TISD volunteers In Public Schools and their representatives and volunteers from all claims or liabilities of any kind arising out of my participation in this event, even though that liability may arise out of my negligence or carelessness in this part of said release. I further grant my permission to Texas High School, Ths Volunteers In Public Schools, and TISD to use any photographs, videotape, recording, and other record of this event.

Print Name: ___________________________________________ date: __________________________________

Sign Here*: ____________________________________________________________________________________*Parent or legal guardian must sign if participant is under the age of 18.

Please return completed form along with check payable to “Texas High School VIPS” to the following address:

daSH For CaSH – reGIStratIoN attN: darraH mCGuIre

3508 Woodridge • Texarkana, Texas 75503

2017 SPoNSorS

Lucille Cook • valerie & bryan DePriest • andrea Lewis echols • bonnie & Paul Miller • Morgan veterinary Services • Deirdre & Malcolm Smith • Reese Townsend • Leah & Thomas orr