Race/Walk For A Drug Free Bristol


Sugar Hollow Park, 21361 Sugar Hollow Dr., Bristol, VA

6/24/2017


10:00 am. Look for a new (flatter) 5K course at Sugar Hollow Park. More details to follow.

Pre-registration:
(ends 6/22/16)
$20 | Regular
| Registration:
$25
Make checks payable to: The Veritas Foundation
Mail this form to: The Veritas Foundation
415 Cumberland St.
Bristol, VA 24201
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Margie, drug.court@bristolva.org
5K Run/Walk
Male & Female Awards:

Top Overall
Top Masters

Age Groups (top 3)
10 under, 11-14, 15-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70 over
1 Mile Fun Run/Walk
Male & Female Awards:



Age Groups (top 3)
No Awards. Un-timed walk

Race/Walk For A Drug Free Bristol

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 Run/Walk | 1 Mile Fun Run/Walk

*** CIRCLE SHIRT SIZE: YS, 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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