Boys Of Fall 5K Color Run


Ernie Hicks Stadium
Richlands High School, Richlands, VA

10/14/2017


6:00 pm. Join us on October 14, 2017 at 6:00pm for the Boys of Fall 5K Color Run from Richlands High School. The finish line will be through the inflatable football helmet on the 50 yard line of Ernie Hicks Stadium. This event is sponsored by Communities In Schools of SWVA and the Richlands Football Parents Club.

Pre-registration:
(ends 10/13/17)
Adult - $30
Youth 18 Under - $20
| Regular
| Registration:
Adult - $35
Youth 18 Under - $25
Make checks payable to: Communities in Schools of SWVA
Mail this form to: Boys of Fall 5K
ATTN Deborah Wagner
220 Lee Street
Bristol, VA 24201
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Amy Queen, Aqueen@cisofswva.org, (276) 963-5370
Boys Of Fall 5K
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

Boys Of Fall 5K Color Run

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, 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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