Roan Mountain 10K


Roan Mountain State Park, Roan Mountain,

11/4/2017


11:00 AM (Eastern Standard Time)
Part of the Tennessee Running Tour
Roan Mountain State Park
This certified 6.2 mile course is an all road (no trail) race starting Picnic Shelter 3.

Pre-registration:
(ends 10/26/17)
$22.00 (Long sleeve T-shirt)
$10.00 (No T-shirt)
| Regular
| Registration:
$15.00 (No T-shirt)
Make checks payable to: Roan Mt. State Park Running Club
Mail this form to: Meg Guy
Roan Mountain State Park
1015 Hwy 143
Roan Mountain, TN 37687
Headphones are NOT permitted on the course | Strollers are NOT permitted on the course
For more info contact
Meg Guy
Park Ranger II, A-EMT, CIG
Roan Mountain State Park
1015 Hwy 143
Roan MTS, TN 37687
423-772-0190 ext. 107
meg.guy@tn.gov
Roan Mountain 10K
Male & Female Awards:

Top Overall

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

Roan Mountain 10K

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. 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)


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