SFTC Long Distance Series | Special finisher's medal for 1/2 Marathon and Sheep Trophies! |
| Pre-registration: (ends June 3, 2011) |
$25 - 13.1 Run $15 - 5K Run Free - Fun Run | | Regular | Registration: |
$30 13.1 Run $20 5K Run | |
| SFTC King & Queen race: SFTC members receive preregistration discount | ||||
| Make checks payable to: The Varmint | ||||
| Mail this form to: The Varmint, P.O. Box 285, Tazewell, VA 24651 | ||||
| $300 ~ 1st Place (M/F)- 13.1 | $200 ~ 2nd Place (M/F)- 13.1 |$100 ~ 3rd Place (M/F)- 13.1 $100 Savings Bond ~ 1st Place 5K (M/F) | Only preregistered runners are guaranteed a shirt! |
| Headphones are permitted on the course | Strollers are permitted on the course |
| For more info contact Charity McDaniel (276) 979-8044 cmcdaniel@tazewell.k12.va.us | 13.1 miles Male & Female Awards: Overall (top 3) Top Masters Age Groups (top 3) ...14, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65+ | 5K Run Male & Female Awards: Top Overall Age Groups (top 3) ...14, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65+ |
| LAST NAME__________________________________ FIRST NAME_________________________ M.I._______ |
SEX____ DATE OF BIRTH____/____/____ AGE ON RACEDAY_____ E-MAIL____________________________ |
ADDRESS___________________________________________________________________________ |
CITY________________________ STATE_________ ZIP___________ PHONE (_______)_______-___________ |
RACE DAY EMERGENCY CONTACT (NAME AND PHONE)_________________________________________ |
*** CIRCLE EVENT: 13.1 miles | 5K Run |
*** CIRCLE SHIRT SIZE: SM, MD, LG, XL, XXL |
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IN CONSIDERATION FOR ACCEPTING MY ENTRY IN THIS RACE, I FOR MYSELF, MY HEIRS, EXECUTORS AND ADMINISTRATORS, WAIVE AND RELEASE FOREVER ANY AND ALL RIGHTS AND CLAIMS FOR DAMAGES I MAY HAVE AGAINST THE ORGANIZERS AND SPONSORS OF THIS EVENT. I ALSO RELEASE THE ABOVE NAMED FOR ALL CLAIMS OF DAMAGE DEMANDS, AND ACTIONS IN ANY MANNER DUE TO ANY PERSONAL INJURIES, PROPERTY DAMAGE, OR DEATH SUSTAINED AS A RESULT OF MY TRAVELING TO AND FROM AND MY PARTICIPATION IN SAID RACE. I ATTEST AND VERIFY THAT I AM PHYSICALLY FIT AND HAVE SUFFICIENTLY TRAINED FOR THE COMPETITION OF THIS EVENT. IN FILLING OUT THIS FORM, I ACKNOWLEDGE I HAVE READ AND FULLY UNDERSTAND MY OWN LIABILITY AND ABILITY. |
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SIGNATURE_____________________________ DATE_____/_____/_____ (Parent signature if under the age of 18) |