Burnsville Fit Families 5K


Burnsville Town Square, Burnsville, NC

5/12/2018


9am. The Burnsville Fit Families 5K is a community race through downtown Burnsville, North Carolina. With encouragement, competition and athletic camaraderie, race organizers and volunteers hope to grow young runners and promote healthy living, exercise and good health habits for life. The race is held on a USATF certified course.

Pre-registration:
(ends 4/26/18)
$25 - Adults
Free! - 17 under
| Regular
| Registration:
$30 - Adults
Free! - 17 under
Make checks payable to: Graham Children's Health Services (GCHS)
Mail this form to: Graham Children's Health Services (GCHS)
202 Medical Campus Drive
Burnsville, NC 28714
memo note: 5K
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Schell McCall, schell@grahamchildrens.org
5K Run/Walk
Male & Female Awards:

Top Overall

Age Groups (top 3)
Top 3 11 under, 12-14, top 2 15-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70 over

Burnsville Fit Families 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: YS, YM, 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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