Kick Butt's 5K Run/Walk


Old Hancock County High School
418 Harrison St., Sneedville, TN 37869, Sneedville, TN

11/4/2017


9:00 am. The 1st Annual Hancock County Kick Butt’s 5K Run/Walk is a non-profit event to promote healthy tobacco free lifestyle choices. The entry fee is only $3!! and the race will be electronically timed by We Run Events.
T-shirts guaranteed for pre-registered entries by 10/25, Post-race refreshments, Tobacco use prevention materials and incentive booth

Pre-registration:
(ends 11/2/17)
Only $3!! | Regular
| Registration:
Only $3!!
Make checks payable to: Hancock County Rescue Squad, Inc
Mail this form to: Hancock County Rescue Squad, Inc
P.O. Box 207
Sneedville, TN 37869
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Sonya Winkle, sonya.a.winkle@tn.gov
5K Run/Walk Timed
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.
5K Walk Untimed
Male & Female Awards:



Age Groups (top 3)
Non-competitive, no awards

Kick Butt's 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 EVENT: 5K Run/Walk Timed | 5K Walk Untimed

*** 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)


This entry form was generated with the SFTC Calendar Utility at www.runtricities.org