___________________________________________________________________________________________________________ Participant Signature (Custodial Parent or Guardian signature is required if under 18) Date

Maryville High SchoolAttention: Ann Drake, MHS Athletic Booster ClubP.O. Box 6435Maryville, TN 37802-6435M

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OFFICIAL MARYVILLE ATHLETIC BOOSTERS DRUMSTICK DASH 2016 ENTRY FORM(one per person)

Maryville Athletic Boosters Drumstick Dash is Thursday, November 24, 2016 starting at Coulter Grove Intermediate School (CGIS), 2025 Sevierville Road, Maryville, TN 37804. 5K - 8:30am start, 1 Mile Fun Run/Walk - 8:45am start. Proceeds bene�t all athletic programs at Maryville High School (MHS).

Registration fees are listed below. Paper registrations must be postmarked by Saturday, November 19, 2016;online registration must be complete by noon on November 23, 2016; day of race registration at CGIS on November 24, 2016 from 6:30 - 7:30am. Registration forms are available at MHS, 825 Lawrence Avenue, Maryville, TN 37803.Preregistration through paper registration form or on-line is STRONGLY encouraged at https://runsignup.com/Race/TN/Maryville/MaryvilleAthleticBoostersDrumstickDash

Loop course through nearby neighborhoods starting and �nishing at CGIS.

Early packet pick-up will be held on Monday, November 21, 2016 from 4:00 - 7:00pm and Wednesday, November 23 from 2:00 - 5:00pm at Bike ’N Tri, 601 East Broadway Avenue, Maryville, TN 37804.

High-quality, unisex, long-sleeve tri-blend t-shirts for all registrants. Participants registered by Friday, November 4, 2016, are guaranteed a shirt by race day. An additional shirt order will be placed after the race for late registrants and will be available for pick up at MHS.

For the 5K race, prizes will be given to the overall male and female winners, and the top 3 male and female �nishers in the following age groups: 8 and under, 9-11, 12-14, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70+

Timing services are provided by Race Day Solutions. Results will be available at Race Day Events and RunSignUp.com.

For more information on running, walking, volunteering, or sponsoring, please contact Ann Drake, MHS Athletic Booster Club President at (865) 250-9472.

5K RUN 1 MI FUN RUNREGISTRATION TOTALS:

REGISTRATION: $

2XL SHIRT: $

SHIRT ONLY ($30): $

DONATION: $

TOTAL: $

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DATE OF BIRTH:UNISEX T-SHIRT SIZE (CIRCLE ONE):YOUTH - S M L ADULT - S M L XL 2XL* (*$2 EXTRA) REGISTER BY NOVEMBER 4, 2016 TO GUARANTEE A SHIRT BY RACE DAY.

REGISTRATION FEETHROUGH 11:59 PM NOVEMBER 20, 2016:

STUDENT (19 & UNDER) - $30

ADULT - $35

REGISTRATION FEENOVEMBER 21, 2016 - DAY OF RACE:

STUDENT (19 & UNDER) - $35

ADULT - $40

In consideration of your acceptance of the race entry, I waive any and all claims for myself, my heirs, and executors against officials or sponsors of the Maryville Athletic Boosters Drumstick Dash 5K and 1 Mile Fun Run for injury or illness which may directly or indirectly result from my participation. I further acknowledge that I am in proper condition to participate in the event. I also grant permission to all of the foregoing to use any photograph, motion pictures, recordings, or any other record of this event for any legitimate purpose.

PRESENTED BY: