Norris Dam Challenge 12K


Norris Dam State Park, Norris Dam, TN

1/13/2018


Part of the Tennessee State Parks Running Tour
11:00 am (Eastern Standard Time)
Norris Dam State Park

Pre-registration:
(ends 1/4/18)
$22.00 with T-shirt
$10.00 No T-shirt
| Regular
| Registration:
$15.00 No T-shirt
Make checks payable to: Oak Ridge Track Club
Mail this form to: Dorn Kile
975 Bush Rd
Clinton, TN 37716
Headphones are NOT permitted on the course | Strollers are NOT permitted on the course
For more info contact
Dorn Kile & Kirk Beckendor
Oak Ridge Track Club
975 Bush Rd
Clinton, TN 37716
dornkile@bellsouth.net
865-621-3942
Norris Dam Challenge 12K
Male & Female Awards:

Top Overall
Top Masters
Top GrandMasters

Age Groups (top 3)
...19,20-29,30-39,40-49,50-59,60-69,70-79,80...

Norris Dam Challenge 12K

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: 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. STROLLERS ARE NOT ALLOWED ON THE RACE COURSE. PARTICPANTS USING 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