Abingdon Independence Weekend 5k


Virginia Creeper Trail
Abingdon Trailhead, Abingdon , VA

7/3/2021


5k- 9am at the Creeper Trailhead in Abingdon. 2 Mile Walk (Not Timed) begins at 9:30am.

Pre-registration:
(ends 06/30/2021)
15.00 | Regular
| Registration:
20.00 on Race Day
Make checks payable to: Brent Swiney: AHS T&F
Mail this form to: Abingdon High School
705 Thompson Drive
Abingdon, VA, 24210
Headphones are permitted on the course | Strollers are permitted on the course
For more info contact
Brent Swiney
Abingdon High School Track & Field
bswiney@wcs.k12.va.us
Abingdon Independence Weekend 5k
Male & Female Awards:

Top Overall
Top Masters
Top GrandMasters
Top Sen.GrMasters

Top Age Groups
...20,21-30,31-40,41-50,51-60,60...

Abingdon Independence Weekend 5k

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:

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)


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