Packet Pickup : At Doe River Gorge from 3:30 p.m. – 5:30 p.m. |
| Pre-registration: (ends 8/27/2022) |
Kids $45 June 1 - August 27 Mini $55 June 1 - August 27 Max $65 June 1 - August 27 | | Regular | Registration: |
Kids $50 Race Day Mini $60 Race Day Max $70 Race Day | |
| Make checks payable to: Goliath at the Gorge | ||||
| Mail this form to: 3101 Browns Mill Rd Suite 6-182 Johnson City TN 37604 | ||||
| Headphones are permitted on the course | Strollers are permitted on the course |
| For more info contact The Goose Chase | Goliath at the Gorge MAX Male & Female Awards: Overall (top 3) Top Masters Top GrandMasters Age Groups (top 3) Age groups (top 3): 15-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70 over. | Goliath at the Gorge MINI Male & Female Awards: Overall (top 3) Top Masters Top GrandMasters Age Groups (top 3) Age groups for both Mini and Max (top 3): 12-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70 over. |
| 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: Goliath at the Gorge MAX | Goliath at the Gorge MINI |
*** 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) |