In consideration of acceptance of this entry, I the undersigned intending to be legally bound, do hereby, for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I may have against the race director and officials, the City of Bridgeport, HI-TEK Racing, LLC, MS Running Productions, their representatives, any and all race sponsors and supporters, volunteers, their agents, successors and assigns, for any and all injuries suffered by me in said event. I assume all risks with entering this event, including but not limited to falls, contact with other participants, effects of weather, including high heat and humidity, extreme cold or wind, traffic and the condition of the road. All such risks being known and appreciated by me. I attest and verify that I am physically fit and sufficiently trained for the completion of this event. Further, I hereby grant full permission to any and all the foregoing to use my photographs, videotapes, motion pictures, recordings, or any other record of this event for any legitimate purposes without compensation or remuneration.
CIRCLE: INDIVIDUAL or TEAM (Include team entries together)
LAST NAME:______________________________________ FIRST NAME: ___________________ SEX:___________ DOB: _______________ AGE ON RACE DAY: _____________ ADDRESS:___________________________________________________ CITY: _________________________________ STATE: ________ ZIP: _________ TELEPHONE: ______________________ EMAIL: _________________________
T SHIRT SIZE: _______ Where did you hear about this event: __________________________________
SIGNATURE: ____________________________________________
(parent or guradian must sign if under 18)
INDIVIDUAL ENTRY FEE: $40.00 Pre Reg - RACE DAY ENTRY $45 UNTIL 250 PERSON LIMIT REACHED ($35 18 & Under)
TEAM ENTRY FEE: $50.00 Pre-Reg - RACE DAY ENTRY $60 UNTIL 250 PERSON LIMIT REACHED ($50 18 & Under) Make check payable to: MS Running Productions 245 Laurel St Stratford, CT 06615