GLOW TRIBE GLOW 3K RUN AND WALK

Dobyns Bennett Football Field

Kingsport, TN, ,

8/12/2016

8:30PM. How often does a 3k (1.8 mile) race come along? Not very often. Come join us on Friday evening at
8:30pm at J. Fred Johnson Stadium (Dobyns Bennett High School) in Kingsport, TN. This short little course will
have all the excitement you need plus the fun and thrill of a Glow Run. This run will finish inside the football
stadium. Proceeds will go to the Dobyns Bennett Student Activities. Yes, you get a great shirt if you preregister.

Pre-registration: $20 preregistered/shirt guaranteed before

8/8/16
$20 Race Night/ No shirt
Make checks payable to: Dobyns Bennett Student Activities
Mail this form to: Glow Tribe Glow 3k
1035 Tree Top Pvt. Dr.
Kingsport, TN 37664

Or

1 Tribe Way
Kingsport, TN 37664
Attn: Joshua French
Headphones are NOT permitted on the course | Strollers are NOT permitted on the course

GLOW TRIBE GLOW 3K RUN AND

WALK
Male & Female Awards:

Top Overall
Top Masters
Top GrandMasters

Age Groups (top 3)

...19,20-29,30-39,40-49,50-59,60...
 GLOW TRIBE GLOW 3K RUN AND 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: 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. 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)

This entry form was generated with the SFTC Calendar Utility at www.runtricities.org