8:40am-2 Mile Walk |
| Pre-registration: (ends 8/13/2013) |
$12-for Sullivan County employees and all first responders $18-all others Pre-registration ends on August 13th. Only pre-registered runners are guaranteed a t-shirt. ***Note*** Size 2X and 3X shirts are available upon request but will requi | | Regular | Registration: |
Race Day Registration-$25 | |
| Make checks payable to: Friends of the Sullivan County Sheriff's Office | ||||
| Mail this form to: ATTN: Leslie Earhart Sullivan County Sheriff’s Office P.O. Box 589 Blountville, TN 37617 | ||||
| Race day registration starts at 7:00am and ends at 8:00am at the main entrance to the Sheriff's Office. |
| Headphones are permitted on the course | Strollers are NOT permitted on the course |
| For more info contact Leslie Earhart (423)279-6042 | Sullivan County Sheriff's Office Hot Pursuit 5K Male & Female Awards: Top Overall Top Masters Top GrandMasters Top Sen.GrMasters Top Age Groups ...14,15-19,20-24,25-29,30-34,35-39,40-44,45-49,50-54,55-59,60... | Sullivan County Sheriff's Office Hot Pursuit 2 Mile Walk Male & Female Awards: Top Overall Top Age Groups ...19,20-29,30-39,40-49,50-59,60... |
| 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: Sullivan County Sheriff's Office Hot Pursuit 5K | Sullivan County Sheriff's Office Hot Pursuit 2 Mile 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. STROLLERS ARE NOT ALLOWED ON THE RACE COURSE. |
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SIGNATURE_____________________________ DATE_____/_____/_____ (Parent signature if under the age of 18) |