Fund-Racing At Vallie View Farm


VallieView Farm
9525 Kingsport Highway, Chuckey, TN

9/18/2021


10:00 am. The Fundracing at the Farm course is full of moderate terrain and beautiful views. We will sprinkle over 20 obstacles throughout the 5K course. No Mud. All proceeds go to equipping youth to realize their potential through the work of LXI. We like pets, but due to liability, no pets are allowed at Vallie View farm events. The only exception are certified service animals that are approved before the day of the event. Regretfully, If you bring a pet they will have to leave.

Pre-registration:
(ends 9/18/21)
$40 | Regular
| Registration:
$40
Make checks payable to: Fundracing at the Farm
Mail this form to: Vallie View Farm , Memo: TCMAC Race 2019
9525 Kingsport Hwy
Chuckey, TN 37641
Parking is going to be in a field. Depending on the weather it could be muddy, so please take this into consideration when driving vehicles that may not be well-equipped for adverse weather conditions.
Headphones are NOT permitted on the course | Strollers are NOT permitted on the course
For more info contact
Mike Vallie 865-603-9753
admin@vallieviewfarm.com
3 Mile Obstacle Course Run
Male & Female Awards:

Top Overall
Top GrandMasters

Age Groups (top 3)
Top 2: 12 under, 13-19, 20-35, 36- 49, 50-59, 60+

Fund-Racing At Vallie View Farm

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, 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. STROLLERS ARE NOT ALLOWED ON THE RACE COURSE. PARTICPANTS USING HEADPHONES ARE NOT ALLOWED ON THE RACE COURSE.

SIGNATURE_____________________________ DATE_____/_____/_____ (Parent signature if under the age of 18)


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