Soled Out Against Hunger 5K Run/Walk


Virginia Creeper Trail
300 Green Spring Road
Abingdon, VA 24210, Abingdon, VA

10/17/2020


8:00 am - Registration
9:00 am - 5K Run/Walk
10:00 am - Awards

Pre-registration:
(ends 09/18/2020)
$25 if paid by 9-11-2020 | Regular
| Registration:
$30 if paid after 9-11-2020
Make checks payable to: Haven of Rest Rescue Mission
Mail this form to: Haven of Rest Rescue Mission
Soled Out Against Hunger 5K
624 Anderson Street
Bristol, TN 37620
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Colton Shankle
cshankle@horbtn.org
423-968-2011
Soled Out Against Hunger
Male & Female Awards:

Top Overall

Age Groups (top 3)
Overall Male, Overall Female, 19 and Under, 20-29, 30-39, 40-49, 50-59, 60 and Over

Soled Out Against Hunger 5K Run/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)_________________________________________

TEAM NAME____________________________

*** 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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