Jingle Bell Stroll 5K Run/Walk Registraion Form - City of Brenham

JINGLE BELL STROLL 5K
The City of Brenham and the Brenham
Runners Association will be hosting the
5 th Annual Jingle Bell Stroll 5K Saturday,
December 3 rd , 2011. The race course
will take runners and strollers on a scenic
path through the streets and
neighborhoods of Brenham. Race will
start and end in the Blue Bell Aquatic
Center parking lot.
Early Packet Pick-Up
Blue Bell Aquatic Center
Friday, December 2 nd 8 AM to 5 PM
Race Day Schedule:
7:30 – 8:15 AM
Packet Pick-Up & Race Day
Registration
Run Begins
8:30 AM
(rain or shine)
DOWNTOWN CHRISTMAS
STROLL
Come check out Brenham’s Downtown
Christmas Stroll the evening of Friday,
December 2 nd !
Events include: Lighted Parade @ 6pm,
Live Entertainment, Gingerbread Tour of
Homes, and Holiday Shopping
Registration Form
Jingle Bell Stroll 5K Run/Walk
Brenham, Texas
To register, submit completed registration form & fee to the Blue Bell Aquatic Center or
send to:
City of Brenham Recreation Department
Jingle Bell Stroll
P.O. Box 1059
Brenham, Texas 77834-1059
First Name: _________________________ Last Name: ___________________________
Gender: Male Female T-Shirt Size: YM S M L XL XXL
Participants registering after November 23 rd are not guaranteed a t-shirt.
City: ______________________________ Age: ____________
Phone: (____) ______________________
Race Fee: BEFORE November 23 rd AFTER November 23 rd
$20 Individual $25 Individual
$10 – Youth 12 and under $15 Youth 12 and under
*One registration form per participant.
Email Address: ____________________________________________________________
Waiver: I know that running a road race is a potentially hazardous activity. I should not enter 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 complete the run. I assume all
risks associated with running/walking this event including, but not limited to: falls, contact with other participants, the effects of
weather, including high heat and or humidity, traffic and the road conditions, all such risks being known and appreciated by me.
Having read this waiver and knowing these facts and in consideration of your accepting my entry, I for myself and anyone entitled
to act on my behalf, waive and release the City of Brenham and all sponsors, their representatives and successors from all claims
or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or
carelessness on the part of the persons named in this waiver. I grant permission to all the foregoing to use any photographs or
any recordings of this event for legitimate purpose.
Signature: ____________________________________
Office Use Only
Date: _____________
Amount Received: ___________ Cash/Check #: ___________ Received By: _______
Credit Card Type: _______ Credit Card #: ____________________ Exp. Date: _______

5K RUN/WALK ROUTE
THE SHOE BANK
We will be collecting gently used athletic
shoes to be distributed by THE SHOE
BANK to those in need.
GOODFELLOWS
In the spirit of Christmas, bring an
unwrapped toy the morning of the
race to be donated to Washington
County Good Fellows! In return you will
receive a Santa Hat! Help bring a smile
to a child’s face this Christmas.
AWARDS
The race will be clock timed, but not
chip timed. Awards will be given to the
top 3 overall finishers. There will be
additional awards for the top male and
female in the following age groups:
10 – 14; 15-19; 20- 29; 30-39; 40- 49;
50-59; 60- 69; 70 and up
All finishers 9 and under will receive a
medal.
P.O. Box 1059
Brenham, Texas 77833-1059
Phone: 979.337.7250
Fax: 979.337.7261
www.cityofbrenham.org
www.brenhamrunnersassociation.com