Fall Harvest 5K Poker Run Entry Form
Please fill out this form to enter the Fall Harvest 5K Poker Run.

Date: 10-31-09
Start Time: 9:00am
Race Description: This 5K course will take you throughout the trails at Hawthorne Park in Eastern Vigo County. Along the course participants will stop at 5 designated locations and "draw" 1 playing card. A trophy will be awarded to the top 2 adults and youth who complete the 5K (by walking or running) with the best 2 Poker Hands in their age group. This is not a timed event. Limited to the first 52 registrants. Registration available thru 8:30 am on Race Day!

All proceeds of the event will go towards Terre Foods Cooperative Market, a cooperative grocery targeted to open in the Spring of 2010. The market will bring local, sustainable, and organic groceries to the heart of downtown Terre Haute.

Email: (optional)
Age on Oct 31st:
T-shirt Size:
Declaration of Authenticity Contract and Waiver
Please read the following statement carefully. To participate, you must sign and return this statement with your application. (typing your name below acts as your signature)
I do hereby waive Terre Foods, and any sponsor or fellow participant, from any liability due to personal injury, loss or damage to any property that may occur during the Poker Run 5K.
Type your full name to act as your signature:
Parent signature if participant is under 18:
Entry Fee: $15 prior to Oct 25th, $20 afterwards.
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