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2021 5K Rib Run Registration
2021 Howells 5K Rib Run/Walk
Starting Time: 8:30 A.M.
Sponsored by Howells-Dodge FCCLA
Saturday, September 11, 2021
Begins by St. John’s Church
322 S. 2nd Street in Howells
Register by Friday, August 27 to receive a T-shirt!!
Registration will begin at 8:00 A.M.
Entry Fee:
$20.00 with T-shirt – $15.00 without T-shirt
(Walk-ins are welcome, but they will not receive a t-shirt.)
*Awards will be given to the top three males and females in each age division.
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Registration Form
Name: _______________________________
Mail Registration Forms To:
Address: _________________________________ Marla Prusa
__________________________________ Howells-Dodge Consolidated
P. O. Box 159 Howells, NE 68641
email address: ______________________________
Gender: _____ Male ______Female Make Checks Payable To:
Howells-Dodge FCCLA
Age Division: (circle one)
10 and under 11-18 19-30
31-50 Over 50
T-shirt Size: (circle one) Adults S M L XL XXL
Children S M L
Waiver: In consideration of your acceptance of my entry, I hereby for myself, my heirs and executors, waive and release any and all rights and claims for damages or injury suffered by me against the Howells-Dodge FCCLA or any volunteer workers. I realize that this is a strenuous physical activity and I verify that I am in good enough physical condition to participate in this event and other sponsored activities.
________________________________ __________________________________
Participant’s Signature Parent/Guardian Signature (if under 19)
