Post 10 1st Annual Heros Supporting Heros 5K Run/Walk

The past few months has been very difficult on our KSP family. We have lost 3 troopers; two to vehicle accidents and one to a deadly shooting. With these occurrences in mind, Post 10 Harlan will be sponsoring a Heros Supporting Heros 5K Run/Walk on November 7, starting at 10:00 AM. All donations and monies collected will be donated to the Supporting Heros foundation which helps EMS, Fire Fighters and Police Officers' families who have lost loved ones such as we have within the KSP family. Attached is the entry form for anyone interested in participating.

Heroes Supporting Heroes 5K Run/Walk

Saturday, November 7, 2015 at 10:00 A.M.

Middlesboro Community Center
705 N. Petersborough Ave Middlesboro, KY 40965

Registration:               $25.00 ($15 if under 18)

Registration starts at 8:30 am

5K t-shirts for all participants (Size not guaranteed if you don’t pre-register)

Checks payable to:      Supporting Heroes

Mail to:                        Trooper Shane Jacobs

Kentucky State Police, Post 10

3319 South U.S. 421

Harlan, KY 40831

Awards:                      Male and Female over-all

1st, 2nd and 3rd place in each age division.

All proceeds go to the Supporting Heroes program


Last Name:  ______________________________ First Name:  __________________________

Address:  ___________________________________________ Phone: ____________________

City: __________________________________ State:  _________ Zip: ____________________

Age: __________    Email: ___________________________

Shirt Size:  Adult ___ Youth ___   S       M       L       XL   Male ____  Female ____

Emergency contact: ______________________________________________________

Waiver of Liability:  In consideration of the acceptance of my entry, I hereby, for myself, my heirs, executors and administrators, do release and discharge any and all sponsors of this 5k Run/Walk of any damages, demands or actions in any manner arising or growing out of my participation in the run/walk.  I attest and verify that I have full knowledge of the risk involved in this event and that I am physically fit and sufficiently trained to participate. I give permission for photographs to be made to be used solely for publicity and training purposes by the Heroes Supporting Heroes 5K.

Signature: _________________________________________________________________________

Parent or Guardian Signature (If under 18)______________________________________________


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