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10th Annual 5K Race for Jordan
Saturday, May 4th, 2013 at 8:00A.M. Cordell Hull Dam, Carthage, TN 37030
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About the Race Please Complete Below:
    The tenth annual Jordan Hackett Foundation 5K Run/Walk and Kids’ 1 mile Fun Run will benefit the Jordan Hackett Foundation. The foundation was setup in memory of Jordan after he passed away October, 2002.
  • T-shirts reserved for those who pre-register by 4/24/13
  • New event – Kids’ 1 mile Fun Run
    • 9:00 AM between 5K and awards
    • Supervision for participants provided during the 5K
    • All participants will receive a t-shirt and medal
Money raised by the 5K will be used to support the following charities and causes:
  • The Ronald McDonald House
  • Vanderbilt Children’s Hospital



**Runners and walkers welcome
**Course has a few dips and rises
**Award given in each category
**Water stations along the way 		Name: ________________________
Address: _______________________
City/State/Zip: _____________________
Phone: ________________________
Age: __________ Sex:_____________
Adult T-Shirt sizes:
XL___ L____ M____ S____
Youth T-Shirt sizes:
6/8____10/12_____14/16_____
2T___3T____4T____
T-Shirts will be reserved for those who pre-register
before 4-24-12

Entry Fee: $20.00

Race Day registration begins at 6:30 A.M.

Make checks payable to:
The Jordan Hackett Foundation
C/O Stephen and Karen Hackett
P.O. Box 45
Carthage, TN 37030
In consideration of being allowed to participate in this event, I, for myself, executors, administrators and child (if signing as a parent), do hereby release and promise not to sue the hosts, sponsors, or any cooperating agencies or employees for any claim or injury that may result from my participation in said event. I know that these events are potentially dangerous, and I have full knowledge of all risks involved. I am physically fit and sufficiently trained to participate in said event.
_______________________________       _________
Signature (Parent or Guardian if minor)       Date