Junior League of Bristol Caterpillar Crawl 5K and Family Fun Walk


Cumberland Square Park, Bristol VA, Bristol, VA

5/9/2015


8:00 am. 2nd Annual Caterpillar Crawl 5K and Family Fun Run/Walk. Professional race management by We Run Events.

Pre-registration:
(ends 4/28/2015)
$20 - 5K, $15 - 1 mile walk/run | Regular
| Registration:
$25 - 5K, $20 - 1 mile walk/run
Make checks payable to: Junior League of Bristol
Mail this form to: Junior League of Bristol TN/VA
PO Box 1448
Bristol, VA 24203
Preregistered runners in both the 5K and 1 mile are guaranteed a t-shirt and goody bag!
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Tasha Foy at 276-591-7093
Donna O'dell at 727-420-0007
5K Caterpillar Crawl
Male & Female Awards:

Overall (top 3)

Age Groups (top 3)
Under 9, 10-13, 14-19, 20-29, 30-39, 40-49, 50-59, 60+
1 Mile Family Fun Run/Walk
Male & Female Awards:




The 1 mile run/walk will be untimed. All participants 12 & under will receive a participation ribbon.

Junior League of Bristol Caterpillar Crawl 5K and Family Fun 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: 5K Caterpillar Crawl | 1 Mile Family Fun Run/Walk

*** CIRCLE SHIRT SIZE: YS, YM, YL, 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.

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


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