Shamrock Shuffle


ETSU Campus-course online, Johnson City, TN

3/20/2021


Start time: 5:30 p.m.

Packet Pickup
Saturday, March 20 at 3 p.m.
ETSU campus
**Finisher medal to first 250 registered participants only**

Pre-registration:
(ends 03/05/2021)
Pricing
$25 Early bird special (now through February 5)
$30 per entrant (February 6 through March 19)
18 & under
$20 Early bird special (now through February 5)
$25 per entrant (February 6 through March 19)
| Regular
| Registration:
$35 Late registration (Packet Pickup on March 20)
$30 Late registration (Packet Pickup on March 20)
Make checks payable to: Southern Appalachian Ronald McDonald House (SARMHC)
Mail this form to: Shamrock Shuffle
3101 Browns Mill Rd
Suite 6-182
Johnson City TN 37604
Costume Contest - Best male, female, boy, girl & group

No post race. See website for Covid procedures.
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Karen or Ashley
info@thegoosechase.org
423.946.0519
Shamrock Shuffle 5k
Male & Female Awards:

Overall (top 3)
Top Masters
Top GrandMasters

Age Groups (top 3)
Age Groups Top 3 Male & Female (9 & Under, 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70 & Older)

Shamrock Shuffle

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, 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.

SIGNATURE_____________________________ DATE_____/_____/_____ (Parent signature if under the age of 18)


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