3K Course Map |
| Pre-registration: (ends 10/4/23) |
$20 thru Sep 10 $30 thru Oct 4 $5 discount for YMCA members (ask for coupon code) | | Regular | Registration: |
$40 Oct 5 thru Oct 7 | |
| SFTC King & Queen race: SFTC members receive preregistration discount | ||||
| Make checks payable to: Unicoi County Family YMCA | ||||
| Mail this form to: Unicoi County Family YMCA 601 Love St Erwin TN 37650 | ||||
| Headphones are permitted on the course | Strollers are permitted on the course |
| For more info contact Unicoi County Family YMCA, 423.743.3361, ucfymca.cfo@gmail.com | 4 Mile Run Male & Female Awards: Overall (top 3) Top Masters Top GrandMasters Age Groups (top 3) 19 AND UNDER, 20-29, 30-39, 40-49, 50-59, 60-69, 70+ | 3K Walk Male & Female Awards: Top Overall Age Groups (top 3) Overall Male & Female, no age groups |
| 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: 4 Mile Run | 3K Walk |
*** CIRCLE SHIRT SIZE: SM, MD, LG, XL, XXL |
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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. |
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SIGNATURE_____________________________ DATE_____/_____/_____ (Parent signature if under the age of 18) |