The Fall Creek Thaw 15K Run


Fall Creek Falls State Park, Pikeville, TN

3/7/2015


Part of the Tennessee State Parks Running Tour
11:00 am (Central Standard Tiime)
Fall Creek Falls State Park

Pre-registration:
(ends 2/27/2015)
$20.00 (Shirt)
$8.00 No Shirt
| Regular
| Registration:
$15.00 (No Shirt)
Make checks payable to: Mach Tenn Running Club
Mail this form to: Roger Gall
%Mach Tenn Running Club
201 Peachtree St
Tullahoma, TN 37388
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Roger Gall/ Mach Tenn Running Club
201 Peachtree St
Tullahoma, TN 37388
931-841-3038
rsgl@cafes.net
Reg2Run.com
The Fall Creek Thaw 15K
Male & Female Awards:

Top Overall
Top Masters
Top GrandMasters

Age Groups (top 3)
...19,20-29,30-39,40-49,50-59,60-69,70...

The Fall Creek Thaw 15K 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 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)


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