Pre-registration: (ends 9/8/23) |
$30 $15 Tusculum Students | | Regular | Registration: |
$35 $20 Tusculum Students | |
Make checks payable to: Tusculum University | ||||
Mail this form to: Tusculum University P.O. 5040, Greeneville, TN 37745 Memo: Glow Run 5K |
Shirts not guaranteed after Sep 8 |
Headphones are permitted on the course | Strollers are NOT permitted on the course |
For more info contact Belle Kemp, Director of Alumni and Community Engagement, bkemp@tusculum.edu | 5K Run/Walk Male & Female Awards: Overall (top 3) Age Groups (top 3) No age group awards. | I Mile Fun Run Male & Female Awards: Overall (top 3) Age Groups (top 3) No other 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 Run/Walk | I 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. STROLLERS ARE NOT ALLOWED ON THE RACE COURSE. |
SIGNATURE_____________________________ DATE_____/_____/_____ (Parent signature if under the age of 18) |