1. No category

5th Annual Trent Holt 5K
Saturday, May 9, 2015
Race Day Check-In 7:00 – 7:45 am
Vertafore
Pulaski, TN
Beneficiaries:
Trent Holt Scholarship Fund
Other Local Organizations
REGISTRATION
Register by April 30th - Individuals-$20 /Families of 4 or more $17 each (includes T-shirt)
Register after May 1st- Individuals-$25 /Families of 4 or more $22 each (includes T-shirt, if
available) Students: High School age and younger-$15 (includes T-shirt)
T-SHIRT ONLY - $12
Name:________________________________________________________________________
Address:_______________________________________________________________________
Phone:____________________Email:_______________________________________________
Age:______________________ Male/Female (circle one)
T-shirt Size (circle one)
Adult- S M L XL XXL
Youth- S M L XL
All participants must sign the waiver statement below:
In consideration of this entry, being accepted, I hereby for myself, heirs, executers, and
administrators waive and release any claims that I may have against the Trent Holt 5K,
Vertafore, the City of Pulaski, TN and any of the sponsors or individuals involved in the Trent
Holt 5K Walk/Run. I certify that I am physically able to participate in this event.
Signature:_____________________________________________Date:____________________
If under 18, parent signature:_____________________________________________________
Please make checks payable to: Trent Holt 5K
Mail check and Registration Form to:
Trent Holt 5K
c/o Wendy Butler
4701 Lewisburg Hwy
Pulaski, TN 38478
Any questions contact Wendy @ 931-205-2230 or email [email protected] or Leigh Ann
@ 931-607-6304 or email [email protected].