Plateau Gobbler Gallop 11K


Cumberland Mountain State Park, Crossville, TN

11/25/2017


11:00 A.M. Central Standard Time
Part of the Tenn State Parks Running Tour
Cumberland Mountain State Park

Pre-registration:
(ends 11/16/17)
$22.00 Long Sleeve Shirt
$10.00 No T-Shirt
Day of Race: $ 10.00 No T-shirt
| Regular
| Registration:
$15.00 (No Shirt)
Make checks payable to: Frostbile Running Club
Mail this form to: Frostbite Running Club
Terry Walter
270 Mimosa Ln
Crossville, TN 38572
Headphones are NOT permitted on the course | Strollers are NOT permitted on the course
For more info contact
Terry Walter
270 Mimosa Ln
Crossville, Tn 38572
931-787-8684
walterfam@frantiernet.net
Plateau Gobbler Gallop 6.7 Miles
Male & Female Awards:

Top Overall
Top Masters
Top GrandMasters
Top Sen.GrMasters

Age Groups (top 3)
...19,20-29,30-39,40-49,50-59,60-69,70-79,80...

Plateau Gobbler Gallop 11K

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,

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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