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, Warren Street Social & Athletic Club of Connecticut, the Town of Branford, the police department of the of Branford, Susan G Komen For The Cure Connecticut, 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. Applications for miniors, under the age of 18, will be accepted with a parent's signature.
PRINT OUT THIS APPLICATION AND MAIL WITH CHECK
CIRCLE ONE: 3.45 MILE RUN 2 MILE FITNESS WALK LAST NAME:____________________________ FIRST NAME: ____________________________ SEX: ________ DATE OF BIRTH: _______________ AGE ON RACE DAY: _______ ADDRESS:___________________________________________________ CITY: _________________________________ STATE: ________ ZIP: _________ TELEPHONE: ___________________________ EMAIL: _____________________________ T SHIRT: S M L XL
I AM A BREAST CANCER SURVIVOR ________ # OF YEARS ____SURVIVOR
APPLICATION OBTAINED FROM: www.hitekracing.com
SIGNATURE: ____________________________________________
(parent or guardian must sign if under 18)
Entry Fees: 3.45 MILE Run Adult Reg: $15.00 By September 27th - $20 After and on race day.
3.45 MILE Run Middle School Reg: $10 By September 28th - $12 After and on race day.
2 Mile Walk: $10.00 by September 28th - $12.00 After and on race day
Make check payable and mail with application to:
Run For The Ribbons
C/O Joe Riccio
13 Valley Court
Branford, CT 06405