Jeff’s Run - 5K
Sunday October 5th, 2003
10am Start
Mt. Loretto CYO Center
Hylan Blvd, Staten Island, NY
Free Kids Run - 11:15am

All Proceeds to go to The Firefighter Jeff Giordano Children’s Playroom at the Cornell Burn Center
DIRECTIONS
From NJ: Take the Outerbridge Crossing to Exit 1—Page Avenue. Turn right onto Page. Go to the third traffic signal. Turn left onto Hylan. Mt. Loretto is approximately 1/4 mile down on left hand side.
From NY: Verrazano Bridge to the SI Expressway to the West Shore Expressway to exit 1—Veteran’s Rd. Turn right onto Veteran’s Rd. Take next right and come back across the Expressway. At intersection, turn right onto Page. Follow as above.
Do you know somebody who’d like to run this event? Please feel free to copy this form and pass it on.
Jeff Giordano, a decorated firefighter, husband and father of three, was also an avid runner. Active in the community, this volunteer soccer coach could be seen daily running along Hylan Boulevard. Logging in over 50,000 miles running, Jeff was the Vice President of the New York Firefighter’s’ Burn Center Foundation and was instrumental in creating the Children’s Playroom at the Cornell Burn Center. This playroom is invaluable in speeding the recovery and healing of children injured in fires and other catastrophic events.
September 11th stole many wonderful people from our lives. Jeff Giordano was one of them. This race is dedicated to his spirit and determination to help others. All proceeds will go to the Firefighter Jeff Giordano Children’s Playroom at the Cornell Burn Center.
Send Entry to : Jeff’s Run, PO Box 70025, Staten Island, NY 10307

Pre-entry Fee $15.00 by September 15th, $20.00 Race Day
Return Entry to: Jeff's Run, PO Box 70025, Staten island, NY 10307
All Check’s Payable to The New York Firefighters’ Burn Center Foundation. (NYFFBCF)

REGISTRATION

Name_____________________________________________________

Date of Birth__________________________________________ M or F

Street_____________________________________________________

City_______________________________________________________

State________________________________________Zip____________

Telephone______________________ email _______________________

Age as of October 5th___________ NYC Firefighter Y or N     Fire Dept Co#____________

Clydesdale/Athena Weight:______________

In Consideration of your accepting this entry, I the undersigned, intending to be legally bound, hereby for myself, my heirs, executors and administrate, waive and release any and all rights and claims for damages I may have against Mt. Loretto, the Firefighter's Burn Foundation,, Tottenville Civic Association, Jeff’s Run Committee and the City of New York and their representatives, successors and assigns for any and all injuries suffered by me in said event. I attest and verify that I will participate in this event as a footrace event, that I am physically fit and have sufficiently trained for the completion of this event and my physical condition has been verified by a licensed Medical Doctor. Further, I hereby grant full permission to any and all forgoing to use any photographs, videotapes, recording or any other record of the event for any legitimate purpose.

Signed_________________________________Date____________________

Parent’s Signature if Under 18 ___________________________