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Scarecrow Classic 5K Run and 1-mile Walk 11/04/2012 Sunday, Nov. 4 at 9 a.m. The 7th Annual Scarecrow Classic has two goals: In 2011, BIAM responded to over 6,100 calls, emails and office visits. It is critical in Maryland to bring attention to individuals with brain injury and their families in order to increase funding for needed services. This is where you come in. We ask that you gather a team of family members and friends to participate in the Scarecrow Classic. Ask neighbors and colleagues to sponsor you and your team. We hope you will take this opportunity to show your support for BIAM! Entry Fees: Mail entry forms to: Scarecrow Classic BIAM, 2200 Kernan Dr., Baltimore, Md. 21207 Snooze Runner: Not an early bird? Away on business that weekend? You may want to register for our snooze runner category. Pay the regular registration fee and your T-shirt will be mailed to you. Packet Pick-up Race Day Directions: From I-95: Take Route 100 West, Exit 43B toward Ellicott City. Take last exit (1A) Long Gate Parkway. At top of exit ramp, turn left on Long Gate Parkway, crossing over I-100. At stop sign, turn right onto Meadowbrook Lane. Pass Park and Ride parking lot and turn left into the second parking lot. Course: Course Map Awards presented to the top three male and female runners overall as well as in the following age groups: 15 and under, 16-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70 and over. Go the extra mile and help us raise money for BIAM's Maryland Brain Injury Resource Center by creating a team and running/walking in honor or memory of someone. Gather pledges or matching funds from your employer and promote this event in your community. A BIAM fleece pullover will be awarded to the top three individuals who raise more than $500 in pledges.Amenities: Commemorative long-sleeve T-shirt to all participants who register by Oct. 26. (Availability and sizes not guaranteed for participants who register after Oct. 26); pre-race warm-up; water and time splits on 5K course; one-mile walk course accessible to wheelchairs and strollers; on-site medical care and aid; pre- and post-event refreshments and snacks; door prizes will be drawn throughout the day (must be present to win). Timing and Scoring: Charm City Run Event Management will manage, time and score the 5K event. Results will be posted by Charm City Run after the race. For more information about the Scarecrow Classic or the Brain Injury Association, contact us at 410-448-2924. BIAM is a 501(c)3 nonprofit. Beneficiary: Brain Injury Association of Maryland's Maryland Brain Injury Resource Center
_______________________________________________________________________________ PLEDGE FORM BELOW AND PRINTABLE FORM Signature of parent or guardian if under 18 Date Mail form and entry fee to: Scarecrow Classic - BIAM 2200 Kernan Drive Baltimore, MD 21207 Phone Name Address T-Shirt Size: Child S M L Adult S M L XL Other ____ There is an additional $10 charge for sizes over XL. Date of Birth Age on race day Waiver: In consideration of the acceptance of my entry I, for myself, my executors, administrators and assignees, hereby release and discharge the Brain Injury Association of Maryland, Charm City Run Race Director, Howard County Dept of Recreation and all other volunteers and sponsors of all claims of damages, demands, actions whatsoever in any manner arising out of my participation in this event. I attest that I have full knowledge of the risks involved in this event and I am physically fit and sufficiently trained to participate. I understand I may be photographed at this event or during related activities, and I agree to allow my photo, video, or film likeness to be used for any legitimate purpose. Teams and PledgesGo the extra mile and help us raise money for BIAM’s Resource Center …. create a team and run/walk in honor or memory of someone, get pledges or matching funds from your employer, and promote this event in your community. For more information about the Scarecrow Classic or brain injury, contact us at 410-448-2924 or info@biamd.org. BIAM is a 501 (c)3 non-profit. _________________________________________ Team Name _________________________________________ Email Payment q Check q VISA q Mastercard Amount $ _________ Exp. Date ___________ Card # ____________________________________ ___________________________________________________ Card Holder Name _________________________________________________ Card Holder Signature Signature Date q 5K Run/Walk q 1M Walk q Snooze Runner Sex q Male q Female City State Zip Participant Name __________________________________________________________________ Please make checks payable to: BIAM q YES! My company has a matching gift policy. (Please enclose necessary forms and other information.) Sponsor: ________________________________________________________________________ Street Address:____________________________________________________________________ City/State/Zip: ____________________________________________________________________ Amount Collected: ________________________________________________________________ Sponsor: ________________________________________________________________________ Street Address:____________________________________________________________________ City/State/Zip: ____________________________________________________________________ Amount Collected: ________________________________________________________________ Sponsor: ________________________________________________________________________ Street Address:____________________________________________________________________ City/State/Zip: ____________________________________________________________________ Amount Collected: ________________________________________________________________ Sponsor: ________________________________________________________________________ Street Address:____________________________________________________________________ City/State/Zip: ____________________________________________________________________ Amount Collected: ________________________________________________________________ Sponsor: ________________________________________________________________________ Street Address:____________________________________________________________________ City/State/Zip: ____________________________________________________________________ Amount Collected: ________________________________________________________________ Sponsor: ________________________________________________________________________ Street Address:____________________________________________________________________ City/State/Zip: ____________________________________________________________________ Amount Collected: ________________________________________________________________ Total Amount Collected: _____________________ Pledges Do more! BIAM is a growing organization and we have seen a tremendous increase in the need for our services. We do not receive any state or federal funding. Every dollar we raise goes back into providing services for individuals with brain injury. Ask your friends, family and colleagues to support your run/walk by making a pledge. Bring your pledge contributions and completed pledge form(s) with you to the event. Did you know that many businesses will match your donation? Ask your company today and raise twice as much for the Brain Injury Association of Maryland Resource Center! Thank you! Contact Name: Kelly Dees Email: Kelly@charmcityrun.com Phone: 410-308-1870 Fax: 410-308-1871 |