Animal Chase Races 2010

Virginia Creeper Trail
Abingdon,VA
5/1/2010
8:00 am 5K (K&Q race)
9:00 am 10K (K&Q race)
9:05 Kids mile
Pre-registration:
(ends 04/30/09)		 $12 - 5K or 10K, run both for $20
$8 - Kids Mile		 | Regular
| Registration:		 $15 - 5k or 10K both for $20
$8 - Kids Mile
King/Queen race: SFTC members receive prereg. discount
$100 - 1st Place male/female 10K
$50 - 1st Place male/female - 5K
Mail this form to:
Washington Co. ADL
P. O. Box 2099
Abingdon, VA 24212
Make checks payable to
ADL
For more info contact
Debbie Blankenship, home 276-628-9546, work 276-646-4344, cell 276-608-4983 		Animal Chase 10K
Male & Female Awards:
Overall (top 3)
Masters (top 3)
GrandMasters (top 3)

Age Groups (top 3)
Overall winners must be present to accept cash prize		Animal Chase 5K
Male & Female Awards:
Overall (top 3)
Masters (top 3)
GrandMasters (top 3)

Age Groups (top 3)
overall winners must be present to accept cash prizes
Animal Chase Races 2010

LAST NAME___________________________ FIRST NAME________________________ M.I.______

SEX____ DATE OF BIRTH____/____/____ AGE ON RACEDAY______ PHONE (_____)_____-_______

ADDRESS_________________________________________________________________________

CITY________________________________________________ STATE______ ZIP______________

E-MAIL___________________________________________________________________________

RACE DAY EMERGENCY CONTACT (NAME AND PHONE)___________________________________

__________________________________________________________________________________

CIRCLE EVENT: Animal Chase 10K | Animal Chase 5K SHIRT SIZE: YM, YL, 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. DUE TO INSURANCE REGULATIONS, STROLLERS AND HEADPHONES ARE NOT ALLOWED ON THE RACE COURSE.

SIGNATURE______________________________________________ DATE________________
(Parent signature if under the age of 18)

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