HERE - Main Street Music Festival

Registraon Form
5 K Race Course
First / Last Name: ________________________
Address: _________________________________
City/State/Zip: ___________________________
Phone/Cell Phone: __________________________
Email: _________________________________
Date of Birth: __________ Age as of 7-30-15: ____
Please Select One:
5K Run____
Male___ Female___
Festival 5k
Entry Fee
$20 Early Registration Run
$_________
$5 Late Registration
$_________
Total Amount
$_________
(postmarked by 7/24/15)
Sponsoredby
Waiver and Release: I, individually, (and/or as a parent, and/or a guardian of the
named minor) for and in consideration of acceptance of this entry in the aforementioned event, do hereby release, remise, waive, and forever discharge the Albertville Chamber of Commerce and any and all other supporting groups of this
said racing event, together with all their officers, agents, officials, and employees,
from any and all liability, claims, demands, actions, or causes damage, including
death, relating to any injury, illness, loss, and further state I am in proper physical
condition to participate in this event. In addition, I agree that my participation in this
event requires that I will not participate with roller blades, skateboards, animals, or
anything which the race director deems dangerous to myself or other participants
and the race director may remove me from this event for a violation of said policy. I
further grant permission to this race and the organization conducting the race and/
or agents authorized by them to use any photographs, videotapes, motion picture,
recordings and any other record of this event for any purpose. I also agree that if
the event is cancelled for any reason that all entry fees are non-refundable.
All bikers must provide their own helmets and wear them during entire race.
Albert vil le, AL
Saturday
August8,2015
Signature:
__________________________
7:00am
(must be signed by parent or guardian if under the age 19)
Date: __________
No refunds or transfers.
Race will only be cancelled/rescheduled under
major weather emergency.
316EastSandMountainDrive-Albertville,AL35950
256-878-3821-Fax256-878-3822
Www.albertvillechamberofcommerce.com
[email protected]
http://facebook.com/AlbertvilleChamber
Festival 5k
Thank you to our 2015
Connuing Sponsors!
Awards
Chip Timing
AwardsCeremonywillbeheld
attheAlbertvilleChamberof
Commercebeginningat
8:30am.
Timingwillbeprovidedusingdisposable
chip-basedshoetags.Shoetagsandbib
numbersarelinked,thereforeyoumust
runwithyourassignedbib.Theshoetag
mustbeattachedbelowthekneeto
registerthecorrecttimeelectronically.
DoNOTswapbibnumbers!!
Early Packet Pick-Up
•
Nolan & Vinson, LLP
•
Alexander
Dodge Chrysler Jeep
Earlypacketpick-upatAlbertville
ChamberofCommerce,316East
SandMountainDrive,Albertville,
AL35950:
Friday,8-7-15
10am-4pm
OverallTopMaleandFemale
Run—$50cashprize.
MedalsawardedtotheTop3
MaleandFemalefinishers
theseagegroups:0-15,16-21,
22-29,30-39,40-49,50-59,
60-69,70+.
M a i l E n t r y To :
Race Day Informaon
Location:AlbertvilleChamberofCommerce
Location:
316EastSandMountainDrive,Albertville
(acrossthestreetfromFoodland)
6:00am—6:45am
Registration
7:00am
5kBegins
8:30am
AwardsCeremony
Albertville Chamber of Commerce
316 East Sand Mountain Drive
Albertville, AL 35950
Call 256256-878878-3821 for more information.