East Rock Challenge

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 New Haven, New Haven Police Department, WSSAC, Connecticut Hospice, Inc., HI-TEK Racing, LLC, 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 ONE:   5K         2 MILE WALK  

LAST NAME:____________________________ FIRST NAME: ____________________ SEX: ____________ DOB: _______________ AGE ON RACE DAY: _____________ ADDRESS:___________________________________________________ CITY: _________________________________ STATE: ________ ZIP: _________ TELEPHONE: ___________________________ EMAIL:: _________________________ T SHIRT: ADULT: S M L XL SIGNATURE: ____________________________________________ (parent or guradian must sign if under 18) Entry Fees: 5K RACE 22.00 By SEP 9th - $27 After and on race day (Under 18 $12.00 & $15.00) 2 MILE WALK: $12.00 By Sep 9th - $15 After and on race day Make check payable and mail with application to: East Rock Challenge C/O Joe Riccio - Race Director PO Box 527 Branford, CT 06405

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