Wellmont/CVA and Eastman Credit Union Present the 3K Moon Walk


J. Fred Johnson Stadium, Ft. Henry Drive, Kingsport, TN

7/15/2017


8:58 PM 3K Walk

Pre-registration:
(ends 7/13/17)
$20 | Regular
| Registration:
$25. Walk Up registration, Jul 15th and 16th.
Only pre-registered walkers guaranteed t-shirts.
Make checks payable to: We Run Events
Mail this form to: Crazy 8s Road Race, c/o We Run Events
622 Georgia Ave.
Bristol, TN 37620
Non-Competitive Walk prior to Crazy 8s 8k Run. Walk the candle-lite streets of Kingsport and finish in J. Fred Johnson Stadium.
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
hank@crazy8s.org
3K Walk
Male & Female Awards:



Age Groups (top 3)
Non-Competitive Walk

Wellmont/CVA and Eastman Credit Union Present the 3K Moon 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 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.

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


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