Hope House Dream 5K Run/Walk Presented by Birth Tissue Donor Services


Meadowview Convention Center
, Kingsport, TN

11/11/2023


8 AM 5K, 8:05 1M Fun Run. All proceeds go to the Hope House of Kingsport, which helps men and women in crisis who are expecting a baby. The race is in continued memory of Melissa Mingle, a local pregnant woman who was killed in October of 2019 as a result of a domestic dispute, with part of the proceeds going toward a college fund for her child. The course will be start and finish at Meadowview Convention Center and run on the beautiful Cattails Golf Course. Nice long sleeve shirt for all entrants.
1 Mile Course Map

Pre-registration:
(ends 9/30/23)		 $30 by 9/30/23 | Regular
| Registration:		 $35 by 11/9/23
$40 11/10 and 11/11/23
Make checks payable to: Birth Tissue Donor Services
Mail this form to: Birth Tissue Donor Services
Re: Hope House Dream Run
2016 Hwy 75, Suite 2
Blountville, TN 37617
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Joy, jmccameron@birthtissuedonor.com 		Hope House Dream Run 5K
Male & Female Awards:
Top Overall

Age Groups (top 3)
14 under, 15-19, 20-29, 30-39, 40-49, 50-59, 60 over		1 Mile Fun Run/Walk
Male & Female Awards:


Age Groups (top 3)
Un-Timed. No awards.

Hope House Dream 5K Run/Walk Presented by Birth Tissue Donor Services

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: Hope House Dream Run 5K | 1 Mile Fun Run/Walk
*** 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)

This entry form was generated with the SFTC Calendar Utility at www.runtricities.org