Duck Island Fall Mile: Kids & Adults


Warriors Path State Park/Duck Island, Kingsport, TN, Kingsport, TN

10/12/2014


Sunday
2:00 PM Kids Mile
2:30 PM Adults Mile
The mile is free & low key (no awards, no shirts) and is part of the KFOM & Adults Series. Need to fill out an entry form to run in the race.

The mile is free & low key: Award and no shirts
Headphones are NOT permitted on the course | Strollers are NOT permitted on the course
For more info contact
Kevin Barham
423-483-4049
Email: crazybuffguy@hotmail.com

This event is owned and managed by SFTC. If you would like to volunteer to help please e-mail or call Kevin Barham at the contact details given above.
Kids
Male & Female Awards:




No Age group awards
Open
Male & Female Awards:




No age group awards

Duck Island Fall Mile: Kids & Adults

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: Kids | Open

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