Run For Your Buns 5k


Franklin Woods Hospital
300 Med Tech Parkway
Johnson City, TN 37604, Johnson City , TN

3/3/2018


This event is brought to you by Franklin Woods Hospital as they highlight March being Colon Health Awareness Month. Race starts at 9 AM. All runners will receive boxers instead of t-shirts.

Pre-registration:
(ends 02/28/2017)
$20 Now - December 31, 2017
$25 January 1 - February 28, 2018
$30 Race Week
*Guaranteed boxers & size deadline Feb. 18, 2018
| Regular
| Registration:
$20 Now - December 31, 2017
$25 January 1 - February 27, 2018
$30 Race Week
*Guaranteed boxers & size deadline Feb. 18, 2018
Make checks payable to: Mountain States Foundation
Mail this form to: Run For Your Buns 5k, 3101 Browns Mill Road, Suite 6-182, Johnson City, TN 37604
Packet Pickup: Friday March 2nd, 4 pm-6:30 pm in the The Wellness Center (Johnson City) gym

** Please note** We will be giving boxers instead of tshirts. Please select you size according to size of boxers.
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Event Management by The Goose Chase
423-946-0519 or info@thegoosechase.org
Run For Your Buns
Male & Female Awards:

Overall (top 3)
Top Masters
Top GrandMasters

Age Groups (top 3)
10 under, 11-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70 over

Run For Your Buns 5k

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, 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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