8:15 am Kid's Paw Print Sprint 8:30 am Women's Paw Print Sprint 8:45 am Men's Paw Print Sprint 9:00 am Wiggle Waggle Walk *Paw Print Sprint Races may be combined based on number of Teams Course measured per USATF guidelines |
| Pre-registration: (ends 04/23/11) |
$12.00 all races | | Regular | Registration: |
$15.00 all races | |
| Make checks payable to: Holly Help | ||||
| Mail this form to: Holly Help Pet Miles c/o Wendy Weidner 313 Dartmouth Drive Bristol, TN 37620 | ||||
| T-shirts guaranteed for preregistered humans, bandanas for animals! Net proceeds donated to Holly Help Spay/Neuter Program. TEAM Name is You and your Pet. Circle event you will be in. Kid's Mile is without a pet and qualifies for KFOM series) * |
| Headphones are permitted on the course | Strollers are permitted on the course |
| For more info contact Wendy Weidner (423)652-2522 kiva18@charter.net | Kid's, Women's and Men's Paw Print Sprint Male & Female Awards: Top Overall Top 3 small breed plus top 3 large breed for each race. Kid's, Men and Women's divisions will be separate. Ribbons to all finishers. Small breed is less than 30 pounds. Kids are age 14 and under. *All pets must have current rabies vaccine.* | Kid's Mile (KFOM) and Wiggle Waggle Walk/Pet Remembrance Walk Male & Female Awards: Ribbons to all finishers. Kid's mile participants are age 14 and under and this race qualifies for Kid's Festival of Miles Series in SFTC. *All pets must have current rabies vaccine as required by law.* |
| 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 EVENT: Kid's, Women's and Men's Paw Print Sprint | Kid's Mile (KFOM) and Wiggle Waggle Walk/Pet Remembrance 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) |