A 5K run/walk in honor and in memory of our military. There will be a brief ceremony at 7:30 am to kick off this family event. Blue and red color will be added to the white shirts during the run/walk.
|$25 before 5/13/18 with guaranteed tshirt; Kids are free (optional shirt is $12)|| | Regular
|$30 after 5/13/18 without a guaranteed tshirt|
|Make checks payable to: Smyth County Chamber of Commerce|
|Mail this form to: 214 West Main Street, Marion VA 24354|
|Headphones are permitted on the course | Strollers are permitted on the course|
|For more info contact|
Smyth County Chamber of Commerce
214 West Main St, Marion, VA 24354
Male & Female Awards:
All Ages run together. Not recommended for children under 15 years of age. Anyone under 18 years old must be accompanied by a responsible adult. an adult.
|LAST NAME__________________________________ FIRST NAME_________________________ M.I._______|
SEX____ DATE OF BIRTH____/____/____ AGE ON RACEDAY_____ E-MAIL____________________________
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)