Let Me Run Bluff City Elementary Community 5K Fun Run/Walk


The Impact Center
335 Carter St.
Bluff City, TN 37618, Bluff City, TN

4/29/2023


9:00 am. Let Me Run 5K is a benefit race for Let Me Run Bluff City Elementary.

Pre-registration:
(ends 3/1/23)
Students age 5-14: $25
Adults: $30
| Regular
| Registration:
Students age 5-14: $25
Adults: $35
Make checks payable to: Bluff City Elementary c/o Let Me Run Head Coach
Mail this form to: Craig A. Gerlach, Head Coach Let Me Run Bluff City Elementary
Bluff City Elementary
282 J. Forrest Thomas St.
Bluff City, TN 37618
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Craig Gerlach, craig.gerlach@sullivank12.net, 423-361-1775
5K Run/Walk
Male & Female Awards:

Top Overall
Top Masters
Top GrandMasters

Age Groups (top 3)
9 under, 10-14, 15-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70 over

Let Me Run Bluff City Elementary Community 5K Fun Run/Walk

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 SHIRT SIZE: YM, YL, SM, MD, LG, XL,

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