Memorial Day Murph


CrossFit Stone Mountain
616 West Main Street
Wise, VA 24293, Wise, VA

5/26/2017


Friday May 26, 2017
Saturday May 27, 2017
Monday May 29, 2017

Pre-registration:
(ends 05/18/17)
$40 | Regular
| Registration:
$40
Make checks payable to: CFSM
Mail this form to: CrossFit Stone Mountain
PO Box 3563
Wise, VA 24293
Memorial Day Murph

Times will vary throughout the weekend. Starting on Friday May 26, Saturday May 27, and Monday May 29. You must schedule a time to complete this WOD to ensure that we have enough room for everyone.

Cost is $40, checks or c
Headphones are permitted on the course | Strollers are NOT permitted on the course
For more info contact
CrossFit Stone Mountain
616 West Main St
Wise, VA 24293
276-321-7216
Memorial Day Murph
Male & Female Awards:




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Memorial Day Murph

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, 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.

SIGNATURE_____________________________ DATE_____/_____/_____ (Parent signature if under the age of 18)


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