Glow Crazy 5k


Greater Kingsport Family YMCA
1840 Meadowview Pkwy
Kingsport, TN 37660, Kingsport, TN

10/8/2022


Come join the fun and be part of the first annual Glow Crazy 5k brought to you by the Greater Kingsport Family YMCA on October 8th, 2022 at 7 p.m. The course will start at The YMCA and will loop through the Meadowview Golf Course and back. Bring the glow and come party with us!

Pre-registration: YMCA Member - $30 through July
Friend of the Y - $35 through July
Kids (6 & under) - $15
| Regular
| Registration:
YMCA Member - $40 Aug - Oct
Friend of the Y - $45 Aug - Oct
Kids (6 & under) - $15
Make checks payable to: Greater Kpt Family YMCA *Memo - Glow Crazy 5k
Mail this form to: Glow Crazy 5k
3101 Browns Mill Rd, Suite 6-182
Johnson City TN 37604
Packet pickup at YMCA
Saturday, October 8, 2022 from 4-6:45 p.m.
Deadline for guaranteed shirt and shirt-size is September 19, 2022
Circle Here for 3XL size option
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
The Goose Chase
(423)946-0519
info@thegoosechase.org
Glow Run 5k
Male & Female Awards:

Overall (top 3)
Top Masters
Top GrandMasters

Age Groups (top 3)
9 & Under, 10-14, 15-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70 & Older

Glow Crazy 5k

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 SHIRT SIZE: YS, YM, YL, 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)


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