Halloween Hustle 5K Glow Run/Walk


Tazewell High School Football Field
Tazewell Elementary
175 Parkview Drive
Tazewell, VA 24651, Tazewell, VA

10/21/2017


7:00 p.m.

Experience the craziness of running through strobe lights and black lights while sporting your favorite Halloween costume, glowing and wearing your swag.
Race starts/ends at the Tazewell High School Football Field located near Tazewell Elementary School.

Pre-registration:
(ends 10/6/2017)
$25 5K
$10 Monster Mash Kids' Dash
| Regular
| Registration:
$30 5K
$10 Monster Mash Kids' Dash
Make checks payable to: CVCA
Mail this form to: CVCA c/o FCS
PO Box 188
North Tazewell, VA 24630
Only pre-registered runners are guaranteed t-shirts.
Costumes are encouraged, not required.
Headphones are NOT permitted on the course | Strollers are NOT permitted on the course
For more info contact
CVCA c/o FCS
PO Box 188
North Tazewell, VA 24630
Contact person: Jennifer Bourne 276-988-5583
Halloween Hustle 5K Glow Run/Walk
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...
Monster Mash Kids' Glow Dash
Male & Female Awards:

Overall (top 3)


...12,0...

Halloween Hustle 5K Glow Run/Walk

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: Halloween Hustle 5K Glow Run/Walk | Monster Mash Kids' Glow Dash

*** 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. 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)


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