| Pre-registration: (ends 04/18/2022) |
$25.00 until 4/18/2022 T-shirt guaranteed until then | | Regular | Registration: |
$30.00 after 4/18/2022 day of registration accepted. | |
| Make checks payable to: GMS Athletic Boosters | ||||
| Mail this form to: 433 E. Vann Rd Greeneville TN 37743 | ||||
| Race day registration accepted. We are asking participants to be mindful of COVID and physically distance from nonfamily members. Please reframe from entering the main campus of Holston Home |
| Headphones are permitted on the course | Strollers are NOT permitted on the course |
| For more info contact Kelly Lamons or Laura Lenker lamonsk@gcschools.net or lenkerl@gcschools.net 423.639.7841 | May the Course Be With You Male & Female Awards: Top Overall Age Groups (top 3) 0-10, 11-15, 16-20, 21-29, 30-39, 40-49, 50-59,60+ |
| 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: 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. STROLLERS ARE NOT ALLOWED ON THE RACE COURSE. |
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SIGNATURE_____________________________ DATE_____/_____/_____ (Parent signature if under the age of 18) |