Kids race 7:00 pm Open race 7:30 pm Fleet Feet Elite race 8:00 pm |
| Pre-registration: (ends 06/1/2021) |
Elite & Open Race $20 through Jan 31 $25 Feb 1 - Mar 31 $30 Apr 1 - June 1 Kids (10 & under) $20 though June 1 | | Regular | Registration: |
Late Registration Elite & Open $35 June 2 Kids $25 June 2 | |
| Make checks payable to: Downtown Mile | ||||
| Mail this form to: The Goose Chase 3101 Browns Mill Rd, Suite 6 - 182 Johnson City TN 37604 | ||||
| Packet Pickup - June 2 - location and time TBA Cash prizes for Elite top 3 male & female. |
| Headphones are NOT permitted on the course | Strollers are NOT permitted on the course |
| For more info contact The Goose Chase (423)946-0519 info@thegoosechase.org | Elite | Kids Male & Female Awards: Overall (top 3) Age Groups (top 3) Top 3 overall Male and Female | Open Male & Female Awards: Overall (top 3) Top Masters Top GrandMasters Age Groups (top 3) 11-19,20-29,30-39,40-49,50-59,60-69,70+ |
| 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: Elite | Kids | Open |
*** CIRCLE SHIRT SIZE: YM, YL, SM, MD, LG, XL, XXL |
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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. |
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SIGNATURE_____________________________ DATE_____/_____/_____ (Parent signature if under the age of 18) |