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Nicole Fleury Run-Walk Oct. 7

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CANTON - SUNY Canton will host the 14th Annual Nicole E. Fleury Memorial 5K Walk-Run on Sunday, Oct. 7. The walk / run will be held on campus and will utilize the beautiful trails that run through the woods behind campus and along the Grasse River.

The popular walk/run is held to honor Nicole’s memory as a SUNY Canton student-athlete and outstanding member of the campus community. Nicole tragically lost her life in a car accident on her way back to campus in November of 1998.

The race will begin at 9:30 and the cost is $15 which includes a long-sleeve t-shirt.

Participants can register the day of the race from 8 to 9 am or register by mail. Past participants are invited to bring a new walker or runner and help break the participation record. Anyone brining a first-year participant will have their name entered for a drawing for an under armour SUNY Canton hoody.

Make Checks Payable To: SUNY Canton College Association – FLEURY RUN and bring or mail completed and signed form (below) to run or mail to: Diane Para, SUNY Canton, Cook Hall 125, 34 Cornell Drive, Canton, New York 13617

Registration form can also be found at www.rooathletics.com

Registration and race start is held adjacent to the campus turf field. For more information contact Diane Para at 386-7015 or email parad@canton.edu.

__________________

REGISTRATION FORM

Name: _____________________________ Male Female



Age ________ Please Circle: Run Walk T-Shirt Only



Adult T-shirt Size S M Lg Xlg XXlg



Youth T-shirt Size S M Lg



Address: _____________________________________________



City: _________________________ State _______ Zip _________

WAIVER/RELEASE FORM

Waiver: In consideration of being allowed to participate, I hereby for myself, my heirs, executors and administrators waive and release SUNY Canton, event organizers and staff, and all other sponsors of this event from damages or claims arising from any and all injuries suffered by me while traveling to, participating in, or returning from this event. I further release the above named parties from negligence to the fullest extent permitted by law. I am aware of and understand the assumed risks both known and unknown and I am aware of the full range of injuries that could occur including permanent disability or death and take full responsibility for those risks. I hereby represent that I am in good health and in proper physical condition to participate in this event.

I fully understand this waiver/release and acknowledge I am signing voluntarily.



Signature: __________________________ Date: _____________

Parental Consent (required if the participant is less than 18 years of age)



As the Parent and/or Legal Guardian to the minor identified on the reverse side of this registration form, I hereby accept and agree to all of the terms and conditions of this Agreement on behalf of the minor in connection with the minor’s participation in this event. If, despite this Agreement, I, or anyone on the minor’s behalf, makes a claim for liability against any of the Released Parties, I will indemnify, defend and hold harmless each of the Released Parties from any such liabilities which may be incurred as the result of such claim.



NAME OF PARENT/LEGAL GUARDIAN (PRINT):



____________________ ____________________________



AGE: _______ DATE OF BIRTH: _______/_______/__________ (of parent/guardian)



SIGNATURE OF PARENT/LEGAL GUARDIAN:



_________________________________ ________________

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