Clay L

Hosted by Singers Glen Volunteer Fire Company & Shenandoah Valley Track Club

Singers Glen Volunteer Fire Company Runners & Walkers - $20.00 (includes tee-shirt)

Run Awards: male and female winners of each age group (1^st, 2^nd & 3^rd place) for the run: (Fire & Rescue Member, 13 & under, 14-19, 20-29, 30-39, 40-49, 50+)

Directions: From Harrisonburg, take 42 North to Green Hill Road (on the left). Follow Green Hill Road for 3.0 miles. Bear left at the intersection with Mt. Zion Road to continue on Green Hill Road. Green Hill Road will turn into Singers Glen Road at the intersection with Turleytown Road. Continue on Singers Glen Road through “downtown” Singers Glen. The fire station and Singers Glen Community Center will be on your left.

Release Form: PLEASE READ BEFORE SIGNING! IT MUST BE SIGNED BY PARTICIPANT (If 18 or older) OR PARENT OR GUARDIAN

I know that participating in a track meet or road race is a potentially hazardous activity. I should not enter unless I am medically able and properly trained. I agree to abide by meet/race rules and any decision of a meet or race official relative to my ability to safely compete an event. I assume all risks associated with my participation in a track meet or road race including, but not limited to, falls, contact with other participants, conditions of the track facility or road. In consideration of the acceptance of my entry, I, for myself and anyone entitled to act on my behalf, waive and release the Shenandoah Valley Track Club & Singers Glen Volunteer Fire Company, their officers, and successors from all claims of liabilities of any kind arising out of my participation in a Shenandoah Valley Track Club or Singers Glen Volunteer Fire Company meet, fun run, or road race.

Signature ______________________________________________________ Date ______________________

Signature of parent or guardian if participant is under age 18 _______________________________________

The proceeds from this event will work toward our goal of endowing the Clay L. Sellers Scholarship fund, which is administered by the Rockingham Educational Foundation, Inc. We welcome donations to help reach this very important goal. If you, your company, or organization would like to make a donation to become a sponsor, please indicate the amount below. All donations $100 and over will have their name placed on the T-Shirt for this year’s run. (must be received by July 1 in order to make it on the shirt)

Donation Amount _________ Name as it should appear on T-Shirt_____________________________

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