Duffield Daze 5K Run/Walk


Big Duffield Daze Tent Parking Lot, Duffield, VA

8/31/2013


7:00-7:30 am Packet Pickup and Race Day Registration
8:00 am Duffield Daze 5K Run
Flat and fast 5K course in conjunction with Duffield Daze Festival. This is a great course to get your 5K PR!! Stick around for Duffield Daze Parade, great food and crafts vendors. Electronic B-tag timing and professional finish line management by We Run Events

Pre-registration:
(ends 8/29/12)
$20 | Regular
| Registration:
$25 Register at race site on Aug 31.
Make checks payable to: Rye Cove Lady Eagle Basketball
Mail this form to: Rye Cove Lady Eagle Basketball
Rye Cove High School
164 Eagles Nest Lane
Duffield, VA 24244
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Kelly Hood, kelly.hood@scott.k12.va.us, 423-502-0870
Jamie Carter, jamie.carter@scott.k12.va.us
Ashley Hood, ashley.hood@scott.k12.va.us
Duffield Daze 5K Run/Walk
Male & Female Awards:

Overall (top 3)

Age Groups (top 3)
14 under, 15-19, 20-29, 30-39, 40-49, 50-59, 60+

Duffield Daze 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)_________________________________________

*** 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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