RACE APPLICATION
Seaford Hot Chocolate 5K Run/Walk
9:00AM Saturday, December 6, 2008
Seaford High School

Proceeds To Benefit Seaford Youth Programs - Hot Chocolate & Bagels afterwards for all runners!

ENTRY FEES: $15.00 pre-registered runners (through 12/3/08)
$20.00 Late registration (12/4/08-12/5/08) - $25.00 Day of Race (12/6/08)
Start & Finish: Seaford High School
REGISTER ONLINE AT WWW.ACTIVE.COM, OR PRINT THIS FORM AND RETURN WITH ENTRY FEE.
RACE RESULTS BY: FINISH LINE ROAD RACE TECHNICIANS (WWW.FLRRT.COM)

Course:  Start Seamans Neck Rd.  100 yards. South of Seaford High School, North to Jerusalem Ave.,
East to Washington  Ave.,  South to Brooklyn Ave., West to Seamans Neck Rd.,
North to Finish at Seaford High School.  

Awards:  Overall Male & Female, Masters (40 plus) Male & Female
Overall Seaford Resident Male & Female (Sponsored by the Seaford Lions Club.)
Medals:  Age Groups: Top 3 Male & Female for 9 and under, then 5 year age groups to 80+
Centipedes Welcome! (minimum 5 runners per centipede) Medal for First place centipede

Race # & T-shirt pick-up: Friday 12/5/08 :  5:00PM - 9:00PM   Saturday 12/6/08 :  7:30AM - 8:45AM
Seaford High School Auditorium, 1575 Seamans Neck Rd., Seaford, NY 11783

Information contact: Michael Di Silvio mjd455@optimum.net  516-384-8536

Mail form and fee made payable to:  Seaford Wellness Council
                                                      3940 Sunset Avenue
                                                  Seaford, NY 11783
___________________________________________________________________________________

Name: ____________________________________________________          Male / Female:_________

Address: __________________________________________________         Chip #:_______________
                                                                                                                                     (If you own one)
Town, State, Zip: ____________________________________________            

Phone: ________________________________ Date of Birth:_________          Age on Race Day:______

E-mail: _____________________________________________

_______________________________________________    Date:_______
Signature (Signature of parent or guardian if under 18 years of age)
In signing this form for myself (or participant below if he/ she is under 18), I understand and agree to absolve Seaford UFSD and The
Seaford Wellness Council, and all sponsors, be they individuals or organizations, singly or collectively, of all blame for any injury,
misadventure, harm, loss or inconvenience suffered in any of the activities associated with the said event.  I attest and verify that I am
physically fit and have sufficiently trained for the completion of this event, and that my physical condition has been verified by a licensed
Medical Doctor.