Light Up the Night 2 Mile Halloween Glow Run


Crockett Springs Park
200 Crockett St
Rogersville, TN 37857, Rogersville,

10/28/2017


Packet Pickup 6 PM
Race Begins 6:30 PM

Pre-registration:
(ends 10/20/2017)
$10 Pre-Registration | Regular
| Registration:
$15 Regular Registration
Make checks payable to: Cherokee High School Cross Country
Mail this form to: Lisa Kirkpatrick
2375 Burem Rd
Rogersville, TN 37857
This is a fun run/walk through historic downtown Rogersville. All proceeds will go to the Cross Country Team. Entry into this race will include a glow necklace and bracelet. Awards to top 5 male and female runner, top 5 male and female costumes.
Headphones are NOT permitted on the course | Strollers are permitted on the course
For more info contact
Lisa Kirkpatrick
lallisonmfd@yahoo.com
423-754-7613
Light Up the Night 2 Mile Halloween Glow Run
Male & Female Awards:

Overall (top 5)


Top 5 male and female runners, Top 5 male and female costumes.

Light Up the Night 2 Mile Halloween Glow 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:

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. PARTICPANTS USING HEADPHONES ARE NOT ALLOWED ON THE RACE COURSE.

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


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