Pre-registration: (ends 5/12/22) |
$25 5K, $35 10K, $50 Boss Hog (5K+10K) | | Regular | Registration: |
$30 5K, $40 10K, $55 Boss Hog (5K+10K) | |
Make checks payable to: Racks By The Tracks | ||||
Mail this form to: Racks By The Tracks 403 Cherokee St Kingsport, TN 37660 |
Headphones are permitted on the course | Strollers are permitted on the course |
For more info contact Frank Lett, flett@visitkingsport.com | 5K Run/Walk Male & Female Awards: Top Overall Age Groups (top 3) 10 under, 11-14, 15-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70+ | 10K Run Male & Female Awards: Top Overall Age Groups (top 3) 10 under, 11-14, 15-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70+ |
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: 5K Run/Walk | 10K Run |
*** CIRCLE SHIRT SIZE: XS, SM, MD, LG, XL, XXL |
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. |
SIGNATURE_____________________________ DATE_____/_____/_____ (Parent signature if under the age of 18) |