Great Pumpkin Classic

In consideration of accepting 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, Trumbull Board Of Education, Town of Trumbull, MS RUnning Productions, HI-TEK Racing,  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.The use of anyone's registration bib by a person it was not issued to is NOT PERMITTED and will result in disqualification of both parties AND will VOID all claims against any and all parties as outlined.
Applications for miniors, under the age of 18, will be accepted with a parent's signature.


CIRCLE ONE:   5K RUN            2 Mile Walk
LAST NAME: ____________________________ FIRST NAME: ________________

SEX:	________ DATE OF BIRTH: __________ AGE ON RACE DAY: _______


CITY: 	_________________________________ STATE: ________ ZIP: _________

TELEPHONE: ___________________________ EMAIL: _____________________________

T SHIRT:  XS   S   M   L   XL


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

Entry Fees: 	$27 Until October 18th - $15 for those 18 and Under
  		        $30 Late Reg  ($15 for those 18 and Under)

Make check payable and mail with application to:
Great Pumpkin Classic
245 Laurel Street
Stratford,CT 06615

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