2nd Annual POWER OF PLAY 5K


YMCA, Martin Luther King, Jr. Blvd. Bristol, TN, Bristol, TN

4/26/2014


Hosted by Burke, Powers, Harty Insurance
8am - 5k Run and 5k Walk
This second annual race through beautiful downtown Bristol TN and VA is a partnership between two cities and two school systems, Bristol Tennessee City Schools and Bristol Virginia Public Schools and each school's physical education program! YMCA's Annual Healthy Kids Day will host a free one-mile kids fun run at 8:10 am. Many activities will begin following the race, so this will be a great family event focusing on health and fitness!!

Pre-registration:
(ends 4/19/2014)
$20- 5k run and 5k walk, $10 for any elementary, middle, or high school student
Participants will pay the convenience fee for online registration
| Regular
| Registration:
$25 - 5k run and 5k walk, $15 for students
Make checks payable to: YMCA-THE POWER OF PLAY 5K
Mail this form to: THE POWER OF PLAY 5k, BTCS, 1236 Volunteer Pky., 2nd Floor, Bristol, TN, 37620
Only preregistered runners and walkers are guaranteed a t shirt
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Landy Mathes, 423-340-1908
Rebecca Craddock, 423-652-9223
2nd Annual POWER OF PLAY 5k
Male & Female Awards:

Top Overall

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...
2nd Annual POWER OF PLAY 5k Walk
Male & Female Awards:




Untimed walk, no awards

2nd Annual POWER OF PLAY 5K

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 EVENT: 2nd Annual POWER OF PLAY 5k | 2nd Annual POWER OF PLAY 5k Walk

*** CIRCLE SHIRT SIZE: XS, 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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