Duffield Daze 5K Run/Walk (Cancelled 2013)


, Duffield, VA

8/31/2013


6:30-7:30 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

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

Awards:


Duffield Daze 5K Run/Walk (Cancelled 2013)

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:

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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