Scarecrow Skedaddle


Founders Park
225 Commerce St, Johnson City, Tennessee 37604, Johnson City, TN

10/21/2018


This 5k & 1-Mile Run is brought to you by Niswonger Children's Hospital. A Modified Race (200-meter) will begin at 1:45 p.m. with the 5k starting at 2 p.m. and 1-Mile Run starting at 2:10 p.m. This is an USATF-Certified course (good for TN state age records) starting and finishing at Founders Park. The event is open to all ages. The entry fee is only $10. Race participants that register by Oct. 5th are guaranteed to receive a t-shirt and finishers medal. After the race, the community is welcome to join us for Family Activities Day.

*Modified Race is for kids who may need assistance with wheelchairs and/or walkers.

Pre-registration:
(ends 10/21/2018)
Only $10!!
*Guaranteed t-shirt & size deadline Oct. 6, 2018
| Regular
| Registration:
Only $10!!
*Guaranteed t-shirt & size deadline Oct. 6, 2018
Make checks payable to: Ballad Foundation *Memo - Scarecrow Skedaddle
Mail this form to: Scarecrow Skedaddle
Attn: The Goose Chase
3101 Browns Mill Road, Ste. 6-182
Johnson City, TN 37604
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
5k
Male & Female Awards:

Overall (top 3)
Top Masters
Top GrandMasters

Age Groups (top 3)
9 & Under, 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70 & Older
1 mile
Male & Female Awards:




No awards given

Scarecrow Skedaddle

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: 5k | 1 mile

*** 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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