Amis Mill 10K


Amis Mill Eatery
Thomas Amis Historical Site established 1780
127 West Bear Hollow Road, Rogersville, TN

3/21/2015


Run 8:30am
No late or race day registration!
Race entries must be postmarked by March 14!

Skelton Law Racing Series
Full breakfast buffet by Amis Mill Eatery!
USATF Certified Course TN14020MS
SFTC King & Queen Competition
Scenic out & back course on rural paved roads
Start & finish overlooking Big Creek Falls at Amis Dam
Awards ceremony 10:00am at Amis Mill Pavilion
Timing and race management by Skelton Law Racing

Pre-registration:
(ends 3/14/2015)
$20.00
Running club members receive $5 discount if pre-register
| Regular
| Registration:
No Late or Race Day Registration!
SFTC King & Queen race: SFTC members receive preregistration discount
Make checks payable to: Skelton Law Racing
Mail this form to: Amis Mill 10K
Law Office of Mark Skelton
121 South Depot Street
Rogersville, TN 37857
Course closes at 1 hour 30 minutes!
For meal planning, race entry must be postmarked by March 14!
For additional buffet tickets, submit guest name & $10.00 per guest with race entry.


Headphones are NOT permitted on the course | Strollers are NOT permitted on the course
For more info contact
Race Director Mark Skelton
423.272.4812 (office)
423.345.2335 (home)
markskelton@markskelton.com
Amis Mill 10K
Male & Female Awards:

Top Overall
Top Masters
Top GrandMasters
Top Sen.GrMasters

Age Groups (top 3)
...14,15-19,20-24,25-29,30-34,35-39,40-44,45-49,50-54,55-59,60-64,65-69,70-74,75-79,80...

Amis Mill 10K

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,

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