Fund-Racing At Vallie View Farm


VallieView Farm
9525 Kingsport Highway, Chuckey, TN

9/18/2021


10:00 am. The Fundracing at the Farm course is full of moderate terrain and beautiful views. We will sprinkle over 20 obstacles throughout the 3 mile race. No Mud. This race benefits LXI of Johnson City..

Pre-registration:
(ends 9/18/21)
$40 | Regular
| Registration:
$40
Make checks payable to: Fundracing at the Farm
Mail this form to: Vallie View Farm , Memo: TCMAC Race 2019
9525 Kingsport Hwy
Chuckey, TN 37641
Parking is going to be in a field. Depending on the weather it could be muddy, so please take this into consideration when driving vehicles that may not be well-equipped for adverse weather conditions.
Headphones are NOT permitted on the course | Strollers are NOT permitted on the course
For more info contact
Mike Vallie 865-603-9753
admin@vallieviewfarm.com
3 Mile Obstacle Course Run
Male & Female Awards:

Top Overall
Top GrandMasters

Age Groups (top 3)
Top 2: 12 under, 13-19, 20-35, 36- 49, 50-59, 60+

Fund-Racing At Vallie View Farm

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: YS, YM, 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. 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