April 21-6am-7:30am packet pick up & registration Virginia High School, 1200 Long Crescent Dr.
Electronic B tag timing & professional race mgmt by We Run Events. Run in 2 states for 1 great cause.
Run from Virginia High School track to Tennessee High School Stone Castle!
Volunteers are needed to assist as course marshals. Volunteer in honor of someone you know that has battled cancer ! If interested, please contact SStout@electro-mechanical.com
|$45 thru March 15 individual $25 each relay runner|
$55 thru April 19 individual $30 each relay runner
| | Regular
|$60 April 20 & 21 individual or $30 each relay runner|
|Counts towards SFTC Long Distance Series|
|Make checks payable to: Electro-Mechanical Corporation|
|Mail this form to: Electro-Mechanical Corporation|
1 Goodson Dr.
Bristol, VA 24201
|Relay runner please enter team name. Individuals can run 1st leg of 2 person relay. Cancer survivors please write CANCER SURVIVOR on your entry form.|
|Headphones are permitted on the course | Strollers are NOT permitted on the course|
|For more info contact|
Mike Stollings, email@example.com
|Half & Half Marathon-Individual|
Male & Female Awards:
Overall (top 3)
Age Groups (top 3)
19 & under, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70+
|Half & Half Relay|
Male & Female Awards:
Top 3 Female Team, Male Team, Co-ed Team
|LAST NAME__________________________________ FIRST NAME_________________________ M.I._______|
SEX____ DATE OF BIRTH____/____/____ AGE ON RACEDAY_____ E-MAIL____________________________
CITY________________________ STATE_________ ZIP___________ PHONE (_______)_______-___________
RACE DAY EMERGENCY CONTACT (NAME AND PHONE)_________________________________________
*** CIRCLE EVENT: Half & Half Marathon-Individual | Half & Half Relay
*** 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. STROLLERS ARE NOT ALLOWED ON THE RACE COURSE.
SIGNATURE_____________________________ DATE_____/_____/_____ (Parent signature if under the age of 18)