39th Annual Tazewell YoungLife Heritage Run


Main Street, Tazewell, VA

7/4/2015


8am - 10K Run
8am - 5K Run

Pre-registration:
(ends 06/27/2014)
$25 - 10K Run
$25 - 5K Run
$25 - Walk
Kids Run - Free
| Regular
| Registration:
$35 - 10K Run
$35 - 5K Run
Race Day Registration
Make checks payable to: Young Life
Mail this form to: YoungLife Heritage Classic, 615 W. Main Street, Tazewell, VA 24651
Only pre-registered guaranteed a t-shirt!
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Brad Pyott
H:(276) 988-4651
C:(276) 971-7854
O: (276) 988-5525
fbp26run@verizon.net
10K Run
Male & Female Awards:

Overall (top 3)

Age Groups (top 3)
...14,15-19,20-24,25-29,30-34,35-39,40-44,45-49,50-54,55-59,60...
5K - YoungLife Heritage Classic
Male & Female Awards:

Overall (top 3)

Age Groups (top 3)
...14,15-19,20-24,25-29,30-34,35-39,40-44,45-49,50-54,55-59,60...

39th Annual Tazewell YoungLife Heritage Run

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: 10K Run | 5K - YoungLife Heritage Classic

*** 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.

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


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