Golden Eagle 5K & 1 Mile Run


Northeast State, Blountville, TN

4/4/2015


Hosted by TriCities Christian School
9:15am-1 mile run 10:00am 5K
The one mile is flat and USATF-certified (eligible for TN state records). It is also both a KFOM and an Adult Mile Series race. If you sign up for the 5K, you can run the mile race for free! $2 discount for SFTC members.

Pre-registration:
(ends 3/28/2014)
$20-preregister 5K $15-1 mile 5K runners may also run the 1 mile for free. $2 discount for SFTC members | Regular
| Registration:
$25-5K $15-1 miler
Make checks payable to: TCCS
Mail this form to: TCCS,1500 Highway 75,Blountville,TN37617
Headphones are NOT permitted on the course | Strollers are NOT permitted on the course
For more info contact
Sam Culbertson 423-239-9366 TCCS 423-323-7128
5K Golden Eagle 5K Run/Walk
Male & Female Awards:

Top Overall
Top Masters
Top GrandMasters

Age Groups (top 3)
...9,10-14,15-19,20-24,25-29,30-34,35-39,40-44,45-49,50-54,55-59,60-64,65-69,70...
One mile race
Male & Female Awards:



Age Groups (top 3)
...9,10-14,15-19,20-24,25-29,30-34,35-39,40-44,45-49,50-54,55-59,60-64,65-69,70...

Golden Eagle 5K & 1 Mile Run

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: 5K Golden Eagle 5K Run/Walk | One mile race

*** 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