Pound Heritage Days Glowin Down In The Pound 5K Glow Run


Pound Town Hall, Pound, VA

7/8/2022


Registration begins: 7:00 P.M.
Race begins: 8:00 P.M

| Regular
| Registration:
$25.00
$100.00 for a team of five
Family and Friends Team Challenge is open to any group and any number of team members. Entry forms for all members of a team must be submitted together.
Make checks payable to: Town of Pound Heritage Days
Mail this form to: Town of Pound
P.O. Box 880
Pound, Va 24279
Official race shirt is guaranteed to the first 30 runners to register. Remaining runners may receive a shirt at a later date.
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Leabern Kennedy 276-393-3119
Pound Herirage Days Glowin Down In The Pound 5K Glow Run
Male & Female Awards:

Top Overall
Top Masters
Top GrandMasters

Age Groups (top 3)
…14, 15-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+

Pound Heritage Days Glowin Down In The Pound 5K Glow Run

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)_________________________________________

TEAM NAME____________________________

*** CIRCLE SHIRT SIZE: SM, MD, LG, XL,

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)


This entry form was generated with the SFTC Calendar Utility at www.runtricities.org