Keiki Fun Run Registration 2014

 IN RECOGNITION OF POLICE WEEK
THE HAWAIʻI POLICE DEPARTMENT
AND CRIME STOPPERS HAWAIʻI
PRESENT THE 1ST ANNUAL

RUN TO HONOR KEIKI FUN RUN

 SATURDAY – MAY 17, 2014
LILIʻUOKALANI GARDENS IN HILO

 

To honor the memory of those officers who gave the ultimate sacrifice.
To promote crime prevention through the use of Crime Stoppers.
To promote seat belt use amongst youth and adults.

 An event for the whole family, including food, entertainment, informational and activity booths,
prizes, a water slide for the keiki, and much more.

Start Time:

9:30 AM – Keiki Fun Run (ages 6-14 years)

Check-In & Late Registration:

Keiki Fun Run – 7:00 AM – 9:15 AM

Optional early check-in, shirt & number pick up and late registration:

May 14-16, 2014, 1:00pm-3:00pm at the Hilo Police Station, 349 Kapiolani Street.

 

No Entry Fee:

NO ENTRY FEE and t-shirt provided for first 100 entrants into the Keiki Fun Run.

DEADLINE to submit registration is THURSDAY, May 1, 2014.

For more information, contact Lt. Darren Horio, Community Policing,
at 961-2350; dhorio@co.hawaii.hi.us,
or visit the Hawaiʻi Police Department’s website at
www.hawaiipolice.com.

 


KEIKI FUN RUN REGISTRATION FORM

PLEASE RETURN THIS PORTION

_______________         _______________         M or F         _____________         ____________________
LAST Name (print)          FIRST Name (Print)         Circle          Age on race day           Date of Birth

 

______________________________          ________________          _____          _______          ______________
Street Address                                                            City                                             State             Zip Code          Phone

 

Preferred Shirt Size (Circle One):          Youth Medium         Youth Large           Adult Small           Adult Medium

 

SEAT BELT USE PLEDGE

Being a participant of this Click It or Ticket event, I pledge that I am aware of the State of Hawaiʻi laws requiring the use of seat belts for all front and back seat passengers and that all children under four years of age must be properly restrained in a child safety seat, and ages four to seven in a booster seat.

I pledge that I will always properly use my seat belt, whether a front or back seat passenger, and that I will encourage all that ride in a vehicle with me to also use their seat belts as required by law.

 

WAIVER MUST BE READ, AGREED AND SIGNED BELOW BEFORE REGISTRATION IS ACCEPTED:
I know that running a road race is a potentially hazardous activity. I should not enter or participate in this run/walk event unless I am medically able and properly trained. I assume all risks associated with participation in this event including, but not limited to, falls, contact with other participants, the effects of weather, including high heat and/or humidity, traffic conditions on the course, and all such risks being known and appreciated by me. Having read this waiver, and knowing these facts and in consideration of your accepting entry, I, for myself and anyone entitled to act on my behalf, waive and release Crime Stoppers Hawaiʻi, the County of Hawaiʻi, State of Hawaiʻi and all associated 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. All fee’s are non-refundable.

 

Signature of participant: ________________________________________          Date:____________________

 

Signature of parent or legal guardian: ______________________________          Date:____________________

 

Registration may be mailed to: “RUN TO HONOR”, c/o Hawaiʻi Police Dept., 349 Kapiolani Street, Hilo, HI 96720