May The Fourth Be With You 4k


King Commons Park, Johnson City, TN

5/4/2022


This Star Wars themed race is a family friendly event with a kids "Darth Dash"(age 5-10) measuring out to .4 km. We will start the kids dash at 6:30 p.m. The 4k race will begin immediately following the conclusion of the Darth Dash (7 p.m.) You do not want to miss this fun event!!
King Commons Park
Pre-registration:
(ends 5/3/2022)		 4k -
$25 through Jan 31
$30 Feb 1 through Mar 31
$35 Apr 1 through May 3

Darth Dash - Ages 5-10
$10 through Jan 31
$15 Feb 1 through Mar 31
$20 Apr 1 through May 3
 | Regular
| Registration:		 Late registration (packet pickup)
May 4th 4-6:30 p.m.
4k - $40
Darth Dash - $25
Make checks payable to: The Goose Chase
Mail this form to: May The 4th Be With You
3101 Browns Mill Road, Ste. 6-182
Johnson City TN 37604
Circle here for 3XL t-shirt size option
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Event Management by The Goose Chase
423-946-0519 or info@thegoosechase.org 		4k
Male & Female Awards:
Overall (top 3)
Top Masters
Top GrandMasters

Age Groups (top 3)
11-19,20-29,30-39,40-49,50-59,60-69,70+		Darth Dash
Male & Female Awards:
Overall (top 3)

Age Groups (top 3)
5-7, 8-10

May The Fourth Be With You 4k

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: 4k | Darth Dash
*** 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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