Erin Shanley Memorial
5K Race/Breakfast
All Proceeds Benefit
St. Jude Children’s Research Hospital
August 21st, 2022 @ 9:00 AM
Stissing Pond (Lion’s Club Pavilion)
Pine Plains, NY
5K/1 Mile Race start at 9:00 A.M
Registration Due: August 14th, 2022
Race Day Registration 8:00-8:45 AM
Registration (circle one): $10 for 5K
$5 for 1 mile race
$5 for post-race breakfast
Additional $10 for an Erin Shanley Memorial T-Shirt: Size: ____________
(all t-shirt orders MUST be in by July 25th)
Top Male/Female Finishers for each Race Receive Awards!
Directions from Route 82/199 Intersection (Pine Plains): Head west on E. Church St. towards South Main St. Take the second left onto Poplar Ave. Take the first right onto Stissing Ave. Continue towards the Lion’s Club Pavilion parking lot.
Online ordering/payment options are available by going to https://www.facebook.com/ErinShanleyMemorialFoundation
Make Checks Payable To: Mail To:
St. Jude Children’s Research Hospital Valerie Shanley
Attn: 5K Entry
6 Creamery Road
Stanfordville, NY 12581
Application Must Be Signed
I agree by signing that I am in good health and I do hereby for myself, my heirs, executors, administrators and assignees, release and forever discharge the sponsors and all those involved and manning this event, from all claims of any kind arising as a result of my participation in this event.
Signature:__________________________________ Date: _____________
Email Address: _____________________________
If under 18 Parent or Guardian must co sign:_____________________ Date:__________
Please contact Tim Reynolds with questions at (845) 214-7801 or t.reynolds1026@gmail.com