12:30 Awards |
| Pre-registration: (ends 3/31/2009) |
Early Registration before Feb 28th. $18 Registration after March 1st. $22 Early Registration prices end March 31st. Only runners registered before March 19th are guaranteed a shirt. Registration after March 31st or on race day $25. ($22 SFTC) | | Regular | Registration: |
Registration after March 31st or on race day $25. ($22 SFTC) OPEN RACE DAY REGISTRATION 8:30am All students $10 (anytime) Walk $13 (anytime) *STUDENTS running with their school,notify the registration table so your school gets credit. | |
| Make checks payable to: Pathfinders Camp | ||||
| Mail this form to: Pathfinders 4951 Sullivan Gardens Pkwy. Kingsport, TN. 37660 www.pathfindersonline.com | ||||
| Only those registered by March 19th are guaranteed a race shirt. $3 discount for SFTC members. All registered runners will receive free admission to the bluegrass festival held later in April at the camp! Passes in runner bags. |
| Headphones are permitted on the course | Strollers are permitted on the course |
| For more info contact Bentley Hively at Pathfinders (423)349-8078. bentley@pathfindersonline.com | Mountain Goat Foot Derby 5K Trail Run Male & Female Awards: Top Overall Age Groups (top 2) ...13,14-23,24-33,34-43,44-53,54-63,60... | Mountain Goat Foot Derby 5K Walk Male & Female Awards: ...0,0... |
| 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: Mountain Goat Foot Derby 5K Trail Run | Mountain Goat Foot Derby 5K Walk |
*** CIRCLE SHIRT SIZE: SM, MD, LG, XL, |
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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) |