Norwalk Mother's Day 10K

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 Norwalk, Lightfoot Running Club, 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.


PRINT OUT THIS APPLICATION AND MAIL WITH CHECK


OFFICIAL ENTRY FORM (HITEKRACING.COM)
CIRCLE ONE:  10K RACE                  5K HEALTH WALK

LAST NAME: __________________________________ FIRST NAME: _______________________

SEX:	____________ 	DOB: _______________ AGE ON RACE DAY: _____________

ADDRESS:___________________________________________________

CITY: 	_________________________________ STATE: ________ ZIP: _________

TELEPHONE: ___________________________ EMAIL: ______________________
T SHIRT:   S     M      L      XL

SPECIAL CATEGORIES CIRCLE AS APPROPRIATE:      MOTHER         POLICE OFFICER         FIREFIGHTER        

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


Entry Fees: 10K $22.00 By May 6th - $25 after and on race day
             Walkers $12 by May 6th - $15 ater and on race day

Make check payable and mail with application to:
Lightfoot Running Club
Don Capone
7 New Street
Norwalk, CT 06855

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