Teachers Helping Teachers 5K


Church Hill Middle School, Church Hill, TN

4/12/2014


9 AM - 5K Run
Race-day registration from 8 - 8:45 AM.

Pre-registration:
(ends 4/7/14)
Pre-registration cost of $20 before April 7. | Regular
| Registration:
After April 7, registration cost is $25, including any race day registration.
Make checks payable to: Heather Jennings
Mail this form to: Heather Jennings, C/O Church Hill Middle School, 208 Oak Drive, Church Hill, TN 37642
Only preregistered runners are guaranteed a shirt.
Headphones are permitted on the course | Strollers are NOT permitted on the course
For more info contact
Keith Russell @ 423-367-2704 or Heather Jennings @ 423-341-7101
Teachers Helping Teachers 5K
Male & Female Awards:

Overall (top 3)
Masters (top 3)
GrandMasters (top 3)

Age Groups (top 3)
...15,16-20,21-25,26-30,31-35,36-40,41-45,46-50,51-55,56-60,60...

Teachers Helping Teachers 5K

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.

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


This entry form was generated with the SFTC Calendar Utility at www.runtricities.org