Firefly 5K Run/Walk


Covered Bridge Park
3rd Street at the Covered Bridge, Elizabethton, TN

7/1/2022


7:30 PM. Join Main Street Elizabethton for the 2nd annual Firefly 5K. An evening run/walk starting and ending in Covered Bridge Park to benefit Main Street Elizabethton and Downtown Elizabethton revitalization efforts. Electronic B-tag timing by We Run Events.

Pre-registration: $25 Early bird fee. Cutoff TBA. | Regular
| Registration:
$30 Regular fee
$35 Late fee
Make checks payable to: Main Street Elizabethton
Mail this form to: Main Street Elizabethton
136 S. Sycamore St.
Elizabethton, TN 37643
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Courtney Bean, cbean@cityofelizabethton.org
Firefly 5K Run/Walk
Male & Female Awards:

Overall (top 3)
Top Masters

Age Groups (top 3)
14 under, 15-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70 over

Firefly 5K Run/Walk

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: 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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