Sullivan County Sheriff's Office Scorpion 5K Run and 2 Mile Walk


Sullivan County Sheriff's Office, Blountville, TN

9/8/2019


6pm - 5K
6:05pm 2 Mile Walk
Proceeds from the event will go to the SCSO S.W.A.T. team to purchase equipment and safety gear.
Several of our sponsors will be providing food and drinks after the race. We also have several door prizes to give away (must be present to win), so please make plans to stay!

Pre-registration:
(ends 9/1/2019)
$25
Only preregistered participants are guaranteed a shirt.
| Regular
| Registration:
$30 Race Day registration begins at 4 p.m. and ends at 5:30 p.m.
Make checks payable to: Friends of the Sullivan County Sheriff's Office
Mail this form to: ATTN: Aaron Hagy
Sullivan County Sheriff's Office
P.O. Box 589
Blountville, TN 37617
You will also have an opportunity to meet the SCSO S.W.A.T. team and learn more about what they will be doing with the proceeds from the event.
Headphones are NOT permitted on the course | Strollers are permitted on the course
For more info contact
Aaron Hagy
5k@scsotn.com
423-279-6050
Sullivan County Sheriff's Office Scorpion 5K
Male & Female Awards:

Overall (top 3)

Age Groups (top 3)
...9,10-19,20-29,30-39,40-49,50-59,60-69,70...
Sullivan County Sheriff's Office 2 Mile Walk
Male & Female Awards:

Top Overall

Top Age Groups
...19,20-29,30-39,40-49,50-59,60...

Sullivan County Sheriff's Office Scorpion 5K Run and 2 Mile 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: Sullivan County Sheriff's Office Scorpion 5K | Sullivan County Sheriff's Office 2 Mile Walk

*** CIRCLE SHIRT SIZE: XS, 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. PARTICPANTS USING HEADPHONES ARE NOT ALLOWED ON THE RACE COURSE.

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


This entry form was generated with the SFTC Calendar Utility at www.runtricities.org