Stars & Stripes 4 Mile Run & 3K Walk


Covered Bridge Park, S. Main St., Elizabethton, TN

7/3/2015


8:00 PM. Packet pickup and late registration 6-7:30pm. Elizabethton 4th of July celebration with the annual parade. The race benefits the Elizabethton/Carter County United Way. United Way of Elizabethton/Carter County is a nonprofit organization that helps raise funds for eight local agencies to provide the basic needs to citizens in our community. The mission for United Way of Elizabethton/Carter County is to make sure our agencies are meeting the needs of our community. When agencies can provide the basic needs to our citizens, then we become a community that is Changing Lives and Building a Stronger Community.

Pre-registration:
(ends 7/2/15)
$20 by 7/2/15 | Regular
| Registration:
$25 on 7/3/15
Make checks payable to: United Way of Elizabethton/Carter County
Mail this form to: United Way of Elizabethton/Carter County
PO Box 1715
Elizabethton, TN 37643
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Debbie Guy, director@uwayecc.org, 423-543-6975
4 Mile Run - Timed
Male & Female Awards:

Top Overall

Age Groups (top 3)
14U, 15-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70+
3K Walk - Untimed
Male & Female Awards:



Age Groups (top 3)
Untimed Walk - No awards

Stars & Stripes 4 Mile Run & 3K Walk

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: 4 Mile Run - Timed | 3K Walk - Untimed

*** 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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