Bucky's Jingle Bell Run


Summers Taylor Stadium, Jack Vest Rd. Johnson City, TN 37614 with parking in the parking lot directly behind Earth Fare., Johnson City, TN

12/6/2014


10:00 am. 3rd Annual race with Christmas theme on ETSU campus. Fantastic finish inside Summers Taylor Stadium. Proceeds benefit ETSU sports teams. Awards for most festive costumes. Electronic B-tag timing and professional race management by We Run Events.

Pre-registration:
(ends 12/4/14)
$25, Only $5 for ETSU students | Regular
| Registration:
$25, Only $5 for ETSU students
Make checks payable to: Buccaneer Athletic Scholarship Association
Mail this form to: BASA ETSU Athletics, PO Box 70707, Johnson City, TN 37614
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Tori Head, headvl@goldmail.etsu.edu
Bucky's Jingle Bell Run
Male & Female Awards:

Overall (top 3)

Age Groups (top 3)
10 under, 11-14, 15-19, 20-24, 25-29, 30-39, 40-49, 50-59, 60 over

Bucky's Jingle Bell 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 SHIRT SIZE: SM, MD, LG, XL, XXL

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.

SIGNATURE_____________________________ DATE_____/_____/_____ (Parent signature if under the age of 18)


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