*Sunday November 6, 2016 * * St.

Paul Lutheran Church-Danbury*

Early Adult Registration: $20 - Early Student (K-12) Registration: $15
Register by October 23, 2016 to guarantee a T-shirt (No Refunds)
Race day registration: Adult $25 - Student $20 and T-shirts will be on a first come first serve
basis Check in beginning at 1:30PM Race/Walk to begin at 3 PM
Course: Beginning at St. Paul and will continue on the premises through the cemetery behind
and head back up to front to enter into Bass Haven South Mobile Home Park to circle through
and then back to church. This lap will be TWO (2) times in order to meet our 5K! Expect loose
gravel, pavement and grass throughout the course.
Waiver: I hereby declare that I am physically fit to participate, assert and affirm that
participation in the Be a Light in the World 5K Fun Run/Walk is done having voluntarily and
knowing assumed ALL RISKS involved in this special event. I will not hold any member or staff
of St. Paul responsible for any and all injuries I may endure while participating in this event. I
am participating at my own risk.
Name__________________________________ Signature__________________________
Address________________________________ Birthdate______________ Age_________
Email______________________________________ Phone_________________________
Gender:
Shirt Size

Male
Adult: S M L XL

Female
Youth: S M L

Remit registration and payment to: St. Pauls Lutheran Church (memo: Youth Mission) 541 S.
Church Rd. Marblehead, OH 43452
For more information, contact Crystal Chapman: 419-656-9005, Hannah Polanco (419) 3416582 or e-mail hannahpo3@yahoo.com or pastorclyoung@yahoo.com

Prizes will be awarded for top 3 overall male and female runners along with, top 3 runners in
each age bracket:12-under, 13-19, 20-29, 30-39, 40-49, 50-59, 60 and over.
Refreshments and awards following race!! This event is to benefit our youth at St. Paul
Lutheran Church in their mission trip in the summer of 2017!!