Pre-registration: (ends 11/11/2023) |
$25 | | Regular | Registration: |
$30 | |
Mail this form to: Jingle Run For Hope 5K c/o Morristown Regional Cancer Center Morristown Hamblen Healthcare System 908 W 4th N St, Morristown, TN 37814 |
Headphones are NOT permitted on the course | Strollers are NOT permitted on the course |
5K Timed Run/Walk Male & Female Awards: Overall (top 3) Age Groups (top 3) 1-9, 10-14, 15-19, 20-29, 30-39, 40-49, 50-54, 55-59, 60-64, 65-69, 70+ | 5K Untimed Walk Male & Female Awards: Age Groups (top 3) No awards |
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: 5K Timed Run/Walk | 5K Untimed Walk |
*** CIRCLE SHIRT SIZE: YM, 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. PARTICPANTS USING HEADPHONES ARE NOT ALLOWED ON THE RACE COURSE. |
SIGNATURE_____________________________ DATE_____/_____/_____ (Parent signature if under the age of 18) |