KingsportARTS Paint The Town 5K Run/Walk (CANCELLED 2017)


Renaissance Center, 1200 Center St. Start/Finish on Yadkin St., Kingsport, TN

3/20/2016


2 pm. Afternoon race from the Renaissance Center in Kingsport to benefit KingsportARTS. Help us paint the town on a very nice course through surrounding neighborhoods! Shirts are very limited so register early. Electronic timing and professional race management by We Run Events.

Packet pickup & late registration: Renaissance Center, 1200 E. Center St.
12 noon-1:30pm on race day. Look for outside tents.

Pre-registration:
(ends 3/18/16)
25 | Regular
| Registration:
30
Make checks payable to: KingsportARTS
Mail this form to: KingsportARTS, 1200 East Center Street, Kingsport, TN 37660
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Cathie Faust, ccfaust@gmail.com, 423-392-8420
5K Run/Walk
Male & Female Awards:

Top Overall

Age Groups (top 3)
10U, 11-14, 15-19, 20-29, 30-39, 40-49, 50-59, 60+

KingsportARTS Paint The Town 5K Run/Walk (CANCELLED 2017)

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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