Mosheim Fundays 5K


Mosheim Elementary School, Mosheim, TN

6/3/2017


The Mosheim Fundays 5k is back! Come join us for a run in the morning and stay for festivities throughout the day.
Race starts at 8:30 a.m.
Raceday Registration begins at 7:30 a.m.
Cost:
Pre-Registration: $15 (online or by mail; ends May 19th at 3:00 p.m.)
Raceday Registration: $20
Each pre-registered participant is guaranteed a t-shirt. T-shirts will be available for raceday registrants while supplies last.
Race will benefit the West Greene High School Cross Country team.

Pre-registration:
(ends 5/19/2017)
$15 | Regular
| Registration:
$20
Make checks payable to: West Greene High School
Mail this form to: 275 West Greene Drive
Mosheim, TN 37818
Race begins at 8:30; raceday registration begins at 7:30
Cost:
Pre-Registration: $15 (available online or by mail - see below)
Raceday Registration: $20
Each participant will receive a t-shirt on
Headphones are NOT permitted on the course | Strollers are NOT permitted on the course
For more info contact
Alex Smyth (alex.smyth@gcstn.org)
Mosheim Fundays 5k
Male & Female Awards:

Top Overall

Age Groups (top 3)
0-9, 10-14, 15-19, 20-29, 30-39, 40-49, 50-59, 60+

Mosheim Fundays 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: XS, 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. 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