Kidville Race for The March of Dimes


The Virginia Creeper Trail, Abingdon, VA

7/19/2014


Packet pickups begin at 7:30 am.
5k Run/Walk begins at 8:30 am.
1 Mile Fun Run begins at 9:30 am.
Little Ones Half Mile begins at 9:45 am.

Pre-registration:
(ends 07/12/14)
5k Run/Walk - $20
1 Mile Fun Run - $15
Little Ones Half Mile Run - $10
All races have a no T-shirt option, take $10 off the race fee
| Regular
| Registration:
Day of Race Registration
5k Run/Walk - $10
1 Mile Fun Run - $5
Little Ones Half Mile Run - Free
Make checks payable to: Daisha Rasnake, Serena Musick. and Margo Sexton. Please Put Kidville Race on the memo line.
Mail this form to: Kidville Race
PO Box 971
Abingdon, Va 24212
Prizes will be drawn including all registrants. Top 3 places per age group receive awards. There will be snacks and lots of fun!
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Serena Musick
serenamusick@yahoo.com
(276) 791-6922
5k Run/Walk
Male & Female Awards:

Overall (top 3)


...9 & under, 10-12, 13-18, 19-24, 25-30, 31-40, 41-50, 51-60, 61-70, +71
1 Mile Fun Run/Little Ones Half Mile Run
Male & Female Awards:




5 & Under (Little Ones race only), 6-9, 10-12

Kidville Race for The March of Dimes

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 Run/Walk | 1 Mile Fun Run/Little Ones Half Mile Run

*** CIRCLE SHIRT SIZE: YT, YS, YM, YL, XS, 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)


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