Fit4Life 5k Glow Run


The Wellness Center, Johnson City, TN

8/11/2017


Come join the fun and be a part of the Fit4Life 5k Glow Run at The Wellness Center in Johnson City on August 11, 2017at 8 PM. This is a great way to celebrate the end of Summer. This Eighties themed event will be equipped with plenty of neon style Glow items, DJ and other fun family activities at The Wellness Center.

Pre-registration:
(ends 08/06/17)
$20 per person (Now through August 6, 2017)
$25 per person (Race Week Registration)
DEADLINE for guaranteed shirt & size is August 1st.
Make checks payable to: Mountain States Health Alliance
Mail this form to: Fit4Life 5k, 3101 Browns Mill Road, Suite 6-182, Johnson City, TN 37604
This is a fun for the entire family. Please dress in your favorite 80's attire as we will be giving out awards to the Best of the Best.
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
For more information, please contact us at info@thegoosechase.org.
Fit4Life 5k
Male & Female Awards:

Top Overall
Top Masters
Top GrandMasters

Age Groups (top 3)
...9,10-19,20-29,30-39,40-49,50-59,60-69,70...
Costume Contest
Male & Female Awards:

Top Overall
Top Masters
Top GrandMasters

Age Groups (top 3)
Best Female Costume, Best Male Costume, Best Family/Team Costume, Overall Best Costume

Fit4Life 5k Glow 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: Fit4Life 5k | Costume Contest

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


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