Baileyton Celebration 5K Road Race


Baileyton Celebration , Baileyton, TN

9/7/2013


6 P.M.

Pre-registration:
(ends 8/31/13)
$8.00 (High School and under)
$12.00 (All others)
$1.00 discount to SFTC Members
| Regular
| Registration:
$10.00 (High School and under)
$15.00 (All others)
SFTC King & Queen race: SFTC members receive preregistration discount
Make checks payable to: Baileyton Celebration 5K
Mail this form to: Ms. Diane McAmis, 40 Light Ln, Greeneville, TN 37745
Headphones are NOT permitted on the course | Strollers are NOT permitted on the course
For more info contact
Ms. Diane McAmis
423) 234-7702
Baileyton Celebration 5K
Male & Female Awards:

Top Overall
Top Masters

Age Groups (top 3)
.....11,12-15,16-19,20-24,25-29,30-34,35-39,40-44,45-49,50-54,55-59,60-64,65-69, 70 and older

Baileyton Celebration 5K Road Race

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