<p>APRIL 18, 2015 SUGAR CREEK CHURCH 5K RUN/WALK For the American Cancer Society  $ 10.00 Pre-Registration (must be received by April 10th)  $ 15.00 Registration Day of Race  Same course this year with several rolling hills throughout the country side of Campbellsburg, IN  Registration starts at 8 a.m. at Sugar Creek Church 11025 Saltillo/Bono Road Campbellsburg, IN  Race starts at 9 a.m.  Mail Completed Registration & Signed Waiver to: Sugar Creek c/o Kim Wallace, 2187 N. Smedley Rd. Campbellsburg, IN 47108  For more information contact Dana at 812-755-4899 or email [email protected]  Make checks payable to: Sugar Creek Relay for Life ______</p><p>Last Name First Name Middle Initial</p><p>Address City State Zip Code</p><p>Phone Number Email Date of Birth Mo/Day/Year</p><p>Age on Race Day Gender M/F</p><p>Runner Walker Donation Only Donation Amount $ </p><p>In Honor Of In Memory Of </p><p>RELEASE AND INDEMNIFICATION – READ BEFORE SIGNING: The signing of this entry blank and the participation in the Sugar Creek Church 5k Run/Walk is with full knowledge of the risks involved therein and the undersigned individually and/or as parent or guardian assumes the risk of any injury, sickness or health defect including death, resulting from or received during participation in the races, and further releases and agrees to save harmless Sugar Creek Christian Church, it’s committees, sponsoring and assisting agencies and individuals from any liability, damage, claim or judgment that may result from or arise out of the participation of the participant in this race. I grant permission to the photographed, videotaped, and recorded for all media usage.</p><p>Signature (signature of parent if participant is under 18)</p>