Last Name______________________ First Name ___________________ Sex ___
Mailing Address_________________________________________________________
City____________________________________ State ____ Zip ________________
E-Mail _________________________ Phone ________________ Birth date _____
Track Club _____________________________________ Age on 7/26/03 _______
Event Circle one 5 K ($10 no shirt $15 with shirt $20 Race day)
1 Mi ($1 no shirt $5 with shirt )
T-Shirt Size
Circle one Adult: Small Medium Large Xtra-Large
Fee Enclosed: $_________
Join the Asheville Track club
$7.50 Aug-Dec(regular Jan-Dec $15) $_________ ($7.50 for New Members Only)
Total enclosed: $_________
Waiver: Upon acceptance of my entry, I for myself my heirs & assigns,
hereby release the City of Asheville, officials, sponsors & volunteers
of the Bele Chere 5K Run and 1 Mile Fun Run and Asheville Track Club,
Inc from any and all liability arising from illness, injury or death I
may suffer as a result of my participation in the events. I attest that
I am physically able and have sufficiently trained for the event and am
aware that participation in this event could result in physical injury.
Should officials determine that completion of the event would be injurious
to my health, I consent to be removed from the event and treated by
designated medical personnel. I agree to accept the decisions of the
officials as final.
Signature of Entrant _______________________________ Date ____________
Signature of Parent/Guardian (if participant is under 18)
_______________________________________________ Date ___________
Make Checks Payable to: The Asheville Track CLub
Mail to: ASHEVILLE TRACK CLUB, C.O. Wayne Stanko, 26 Greenleaf Circle
Asheville, NC 28804 On site registration available at Jus' Running
***** Deadline for Mail in entry is 20 July.