7:30 a.m. start time |
| Pre-registration: (ends 5/19/2023) |
Please read prices in order - Solo, Band(2 -4 person relay) Now through Feb 1 - $45,$30 Feb 2 through April 1 - $55,$40 April 2 through May 18 - $65,$50 | | Regular | Registration: |
Late Registration - Solo, Band(2-4 person relay) May 19 & 20 (packet pickup) - $70,$55 | |
| Make checks payable to: Music & Miles Half | ||||
| Mail this form to: Music & Miles 3101 Browns Mill Rd Suite 6-182 Johnson City TN 37604 | ||||
| Remix (virtual) - Now through Feb 1 - $25 Feb 2 through April 1 - $30 April 2 through May 18 - $35 May 19 & 20 (packet pickup) - $40 |
| Headphones are permitted on the course | Strollers are NOT permitted on the course |
| For more info contact info@thegoosechase.org 423.946.0519 | Solo Male & Female Awards: Overall (top 3) Top Masters Top GrandMasters Age Groups (top 3) ...19,20-29,30-39,40-49,50-59,60-69,70... | Quartet | Duet Male & Female Awards: Top Overall Age Groups (top 3) CIRCLE ONE: Band (2-4 person) Top 3 Co-ed, Male, Female |
| 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)_________________________________________ |
TEAM NAME____________________________ |
*** CIRCLE EVENT: Solo | Quartet | Duet |
*** 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. STROLLERS ARE NOT ALLOWED ON THE RACE COURSE. |
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SIGNATURE_____________________________ DATE_____/_____/_____ (Parent signature if under the age of 18) |