Champions 4 Children 5K


Sugar Hollow Park
, Bristol, VA

9/8/2018


Postponed till April 2019 due unforeseen circumstances. Hope we will see you then!

Pre-registration:
(ends 9/5/2018 )
Champions 4 Children Trail 5K $25
Super Hero Fun Run Free
| Regular
| Registration:
Champions 4 Children Trail 5K $30
Super Hero Fun Run Free
Make checks payable to: Highlands Community Services
Mail this form to: Highlands Community Services
Attn: C4C 5K
610 Campus Drive
Abingdon, VA
24210
Strollers and head phones Ok for Kids' Fun Run.
Since this is a Super Hero run, there will be capes instead of T-Shirts!
Headphones are NOT permitted on the course | Strollers are NOT permitted on the course
For more info contact
Alexandra Veatch 276-525-1574 or aveatch@highlandscsb.org
Champions 4 Children 5K
Male & Female Awards:

Top Overall
Top Masters
Top GrandMasters

Age Groups (top 3)
...9,10-19,20-29,30-39,40-49,50-59,60...

Champions 4 Children 5K

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

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


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