The Bat 5 Miler


Rocky Fork State Park in Flag Pond, TN, Flag Pond ,

10/24/2020


Part of the Tennessee State Park Running Tour. 11am start
5 mile road race to benefit the Friends of Rocky Fork State Park

Pre-registration:
(ends 10/17/20)
$9 for SFTC members
$10 non-members
T-shirts are an extra $12 ($14 for XXL and XXXL)
| Regular
| Registration:
$20
There will NOT be extra t-shirts, so if you want one preregister.
Make checks payable to: Friends of Rocky Fork State Park
Mail this form to: The Bat
C/o Lisa Hazlett
1100 Bellingham Drive
Kingsport, TN 37660
Headphones are NOT permitted on the course | Strollers are NOT permitted on the course
For more info contact
Lisa Hazlett
Lhazlett@k12k.com
The Bat
Male & Female Awards:

Top Overall
Top Masters
Top GrandMasters
Top Sen.GrMasters

Age Groups (top 3)
...10,11-15,16-20,21-25,26-30,31-35,36-40,41-45,46-50,51-55,56-60,61-65,66-70,71-75,76-80,80...

The Bat 5 Miler

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: 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. 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)


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