Panera Bread Bucks 5k Series Application Form 2010


Family Discount
For immediate family members who pre-register by mail (only), the 5k fee will be reduced to $15 each after the first two members. The applications must be combined and postmarked no less than 7 days before the race.

Register for all 7 5k's

Register for all 7 races before March 13th and receive a discounted price plus a moisture wicking 2010 Panera Bread Bucks 5k Series Short Sleeve T-shirt.

ENTRY FEES
  
All 7 races before 3/13 $150.00
5k postmarked at least 7 day before race
$25.00
5k family (discounted as described above)
$15.00
5k postmarked within 7 days of race or on race day
$30.00
1 Mile Fun run
$5.00

download a full brochure here (pdf)
 
1. Use keyboard to fill in form.
2. Print
3. Pay total with one check payable to Bucks 5k Series and mail to Bucks 5k Series, PO Box 421, Fountainville, Pa. 18923
4. No refunds of entry fees are possible
Last Name
First Name
Age on 6/5/10 Sex - - Telephone
Address
City
State - Zip
E-mail
 
Pump & Run
5k
$25
before
7 days
5k
$30
within
7 days
5k
$15
Family
Plan
1 Mile
Fun Run
$5
Additional
Donation
Sub Total
CB Family YMCA
$
$
NH-Solebury
$
$
BV Trailblazer
$
$
Cornerstone 5k (Lab Fitness)
$
$
JK-M SERTOMA  
$
$
Doylestown  
$
$
Chalfont Challenge  
$
$
All 7 5k Races $150
All 7 races before 3/13
$
$
T-shirt size
S
M
L
XL
  
 
Grand Total
$
Each runner will be required to sign a waiver on race day. A parent's signature will be required for runners under the age of 18