Mendota 5K River Run & Mile


Mendota Community Center
2562 Mendota Rd
Mendota, VA 24270, Mendota, VA

5/6/2023


9:00 am. Spring run from the Mendota Community Center along the North Fork River and on the beautiful Mendota Trail.

Pre-registration:
(ends 05/04/2023)
$25 | Regular
| Registration:
$30
Make checks payable to: Mendota Community Association
Mail this form to: Mendota Community Association
2562 Mendota VA 24270
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Angie thompson 239-745-7966. Pthompson2000@aol.com
Mendota 5K River Run
Male & Female Awards:

Top Overall
Top Masters

Age Groups (top 3)
14 under, Top 2 in the following: 15-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70 over
1 Mile Fun Run
Male & Female Awards:



Age Groups (top 3)
No awards

Mendota 5K River Run & Mile

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: Mendota 5K River Run | 1 Mile Fun Run

*** 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)


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