The Brave Heart 5k and 1 Mile Fun Walk


Hungry Mother State Park Marion Va
Parking lot #4, ,

6/9/2018


5k race starts at 8:00am
1 mile Fun Walk will begins at 8:15am

Pre-registration:
(ends 06/02/2018)
Pre-registration fee for 5k $25
Pre registration for 1 Mile Fun Walk $15
| Regular
| Registration:
Day of the race is $30 for 5K
$20 for 1 mile fun walk
Make checks payable to: Amy Houck, hospital manager (memo line: The Brave Heart 5K)
Mail this form to: VCA Highlands Animal Hospital
25011 Lee Highway
Abingdon, Va 24211
There will be awards for 1st, 2nd and 3rd male and female.
We are doing this race to raise Money for Laura Mele a veterinary technician at one of our sister hospital. She was diagnosed with Labor induced cardiomyopathy. She is currently awaiting a hea
Headphones are permitted on the course | Strollers are NOT permitted on the course
For more info contact
Brandi Cregger or Amy Houck or Call is at VCA Highlands Animal Hospital 276-628-4115
Brandilyn.cregger@vca.com or Amy.houck@vca.com
The Brave Heart 5k
Male & Female Awards:

Overall (top 3)


NA
1 Mile Fun Walk
Male & Female Awards:




NA

The Brave Heart 5k and 1 Mile Fun 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: The Brave Heart 5k | 1 Mile Fun Walk

*** 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.

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


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