Monroe 5K Trail Run/Walk

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 Town of Monroe, USATF, USATF/CT, 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 and trails. 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.


PRINT OUT THIS APPLICATION AND MAIL WITH CHECK


LAST NAME: _______________________________________ FIRST NAME: _____________________

SEX:	____________ 	BIRTH DATE: _______________AGE ON RACE DAY: _______________

ADDRESS:___________________________________________________

CITY: 	_________________________________ STATE: ________ ZIP: _________

TELEPHONE: ___________________________ EMAIL: ____________________________

TEAM NAME: _______________________________________

T SHIRT:  ADULT:   S    M   L   XL  

SIGNATURE: ____________________________________________
           (parent or guradian must sign if under 18)

Entry Fees: $20.00 By SEP 30 -  $25 After and on race day
$15.00 per person team registration (minimum 10 people) mailed to arrive by September 30 - NEW! Make check payable and mail with application to: Monroe Trail Run 5K Run/Walk P.O. Box 146 Monroe, CT 06468

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