5:30 Warm ups 6:00 Races begin 4:30-8pm: Pasta dinner |
| Pre-registration: (ends 9/4/2009) |
$5 | | Regular | Registration: |
$10 | |
| Make checks payable to: ERC | ||||
| Mail this form to: Eastman Road Race, Eastman Employee Center, Kingsport, TN 37662-5310 | ||||
| Ribbons for all finishers Medals for top 3 M/F Free pasta dinner for all runners, extra dinner tickets $2 2-3yrs: 75yds / 4-5yrs: 150yds / 6-7yrs: 300yds / 8-9yrs: 1/2 mile / 10-11, 12-14yrs: 1 Mile |
| Headphones are permitted on the course | Strollers are permitted on the course |
| For more info contact Amber Nave 423/224-0836 (w) | Youth Runs Male & Female Awards: Age Groups (top 3) 2-3, 4-5, 6-7, 8-9, 10-11, 12-14 |
| 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, XS, SM, MD, LG, |
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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) |