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Adopt A Golden Knoxville's Golden Run 5K & Memory Walk
Sat, Oct 17, 2015
About This Activity
All registration fees go to support Adopt A Golden Knoxville’s rescued dogs!
Date: Saturday, October 17, 2015 (Rain or Shine!) Location: Tommy Schumpert Park, 6400 Fountain City Road, Knoxville, TN 37918 Course Description: Race starts at Greenway’s 0 Mile Marker (at dog parks), runs to Church and back. Timing: Individual times will be managed by the Knoxville Track Club. Dog-Friendly Event: There are three dog parks and drinking fountains at the Park. Runners and walkers are welcome to have their dog(s) participate in the event alongside. All dogs MUST be on leashes at all times unless inside one of the dog parks. Registration and Entry Fees: $10 for children 12 and under (includes t-shirt), Age 13 on up: $20 (Excludes T-Shirt/Goodie Bag) or $25 (Includes T-Shirt/Goodie Bag). Online registration is available until Friday, October 16th at 12noonEST. No refunds. Payment: Pay online or mail registration form along with a check made out to “AGK” to PO Box 11822, Knoxville, TN 37939. Payment must be received prior to start of race. On Race Day, registration and payment will be accepted (cash/check/credit card). Race Schedule: Check-In /Registration: 8AM – 8:45AM. Race: 9AM. Awards/Festivities: 10:20AM Awards: Top 3 youth male, youth female, Top 3 adult male, Top 3 adult female based on age brackets. Results: Complete results will be available on the KTC website at www.ktc.org following the race. Race Etiquette: Due to insurance regulations, roller blades and bicycles are not allowed on the course. All dogs MUST be on a leash at all times. Race Contact: Jessica Popek, Jessica.firstname.lastname@example.org
Full Name: ____________________________________________________________________________
Date of Birth: ___________ Age: _________ Gender (circle): Male Female
Full Address: __________________________________________________________________________
Emergency Contact: __________________________________ ER Phone: _________________________
I will be doing the 5K: ____ Memory Mile: ____ in honor of (animal/person): ______________________
I cannot attend the race but would like to apply my fee in honor of (animal/person): __________________
T-shirt size (circle): S M L XL 2XL
ATHLETE’S RELEASE: I know that running in road races is a potentially hazardous activity. I should not enter and run in this race unless I am medically able and properly trained. I assume all risks associated with running in this road race, including, but not limited to: falls, contact with other participants, the effects of weather,, including high heat and/or humidity, the conditions of the road and traffic on the course; all such risks being known and appreciated by me. Having read this waiver and knowing these facts, and in consideration of your acceptance of my application, I, for myself and anyone entitled to act on my behalf, waive and release Adopt A Golden Knoxville, Knox County, the Knoxville Track Club, and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in the race even though that liability may arise out of negligence or carelessness on the part of the person(s) named in this waiver. I also grant my permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose.
If I am over the age of 18, my electronic signature is valid and approves the Athlete’s Release.
If I am under 18, I must sign this form with a guardian present at check-in on the day of the event. AGK will have the form on file.
_____________________________________________ ____________________________ Athlete’s Signature Date
_____________________________________________ ____________________________ Athlete’s Guardian Signature if under 18 (sign copy at event) Date