BlueDevil 5k/3k


Gentry Stadium Erwin, TN, Erwin,

7/28/2018


8:30 5k and 3k

Pre-registration:
(ends 7-21-2018)
$25 for both race and walk | Regular
| Registration:
$35 for both race and walk
Make checks payable to: UCHS GridIron
Mail this form to: 108 Deaton St Erwin TN 37650
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
John Keasling
jcdkeasling@comcast.net
423-220-6257
BLUEDEVIL 5K RACE
Male & Female Awards:

Top Overall

Top Age Groups
...10,11-20,21-30,31-40,41-50,51-60,61-70,70...
BLUEDEVIL 3K WALK
Male & Female Awards:




NO AWARDS FOR WALK

BlueDevil 5k/3k

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: BLUEDEVIL 5K RACE | BLUEDEVIL 3K 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.

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


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