Run The Gate 5K Run/Walk


Downtown Gate City, VA, Gate City, VA

7/29/2017


8:00 AM

Pre-registration:
(ends 07/20/17)
$20 - 5K Run/Walk | Regular
| Registration:
$25 - 5K Run/Walk
Make checks payable to: Gate City Frontier
Mail this form to: Gate City Frontier
101 E. Jackson Street
Gate City, VA 24251
T-SHIRT guaranteed to the first 75 participants registered.
Proceeds will be donated to restoration of the Gate City Theater. All other donations appreciated.
Race packets can be picked up at The Family Bakery, 101 E. Jackson St., Gate City, VA on
Headphones are NOT permitted on the course | Strollers are NOT permitted on the course
For more info contact
gatecityfrontier@gmail.com

Janet Williams
423-676-5235
Run The Gate 5K Run/Walk
Male & Female Awards:

Overall (top 3)


...19,20-24,25-29,30-34,35-39,40-44,45-49,50-54,55-59,60...

Run The Gate 5K Run/Walk

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)


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