WESTON
MEMORIAL DAY 5K
May 29, 2010 - 8:30am
(Note "Fun Run" registration takes place on Race Day Only)
In consideration of the acceptance of this entry. I do release, Weston High School PTO and any of its members, the Town of Weston and all contributing sponsors from any claim whatsoever from my participation in the event. I attest that I am physicality fit and sufficiently trained to compete in this event.
LAST NAME: _________________________________ FIRST NAME: _____________________________
MAILING ADDRESS: _____________________________________________________________
CITY: ______________________________ STATE: ______________ ZIP: ________________________
AGE: _____ DOB: _______________ SEX: ______ GRADE: _______________ (If Applicable)
SCHOOL: (Circle) WES - WIS - WMS - WHS - OTHER WESTON SCHOOL TEACHER? Y / N
VARSITY TEAM (If Applicable)_____________________ WHS CLUB (If Applicable) ______________
PHONE: __________________________________________________
T SHIRT: S / M / L / XL /
EMAIL:_______________________________________________________________
How did you hear about our race? _________________________________________________________
____________________________________________________
Runners Signature (parent/guardian must sign if under 18 years old)
BIB#: (Official Use Only): ___________________
CHECKS PAYABLE TO:
WESTON HIGH SCHOOL PTO
Weston High School 5K Road Race
115 School Road
Weston, CT 06883
Mail in Registration - $18. Must be received by May 27th! (Same Day Registration - $20)