Parker Road Race Entry Form 2008

 

Photocopies accepted, one person per form, signature required
Please mail completed forms and checks to:
Parker Road Race, 49 Antietam Street, Devens MA  01434

Last Name  First Name          

Address  

City   State  Zip  -

Phone --

Email  

 

Age on Race Day ______________         Male        Female

 

Race:                                     T-Shirt Size:

 2 Mile Race

 

 

 Youth Small

 Adult Small

 5 Mile Race 

 

 

 Adult Medium

 Adult Large

 2 Mile Walk

 

 

 Adult X-Large

 

Under 14: $12; $15 late registration (after May 1st)
Adult: $17; $20 late registration (after May 1st)

Amount Enclosed $                                        

Make tax-deductible checks payable to: Parker Essential Fund

Waiver: (read before signing):
I know that running is a potentially hazardous activity.  I should not enter and run unless I am medically able and properly trained.  I agree to abide by any decision of a race official relative to my ability to safely complete the run.  I assume all risks associated with running in the event including, but not limited to: falls, contact with other participants, the effects of weather, including high heat and / or humidity, traffic and the conditions of the road, all risks being known and appreciated by me.  Having read this waiver and knowing these facts and in consideration of you accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the F.W. Parker Charter Essential School, the race directors, organizers, officials and volunteers, the Parker Essential Fund, the Devens recreation Commission, the town of Devens, the landowners upon whose property the courses are laid, the business sponsors and promoters of the races, USATF and the N.E. Association of USATF from all claims of liabilities of any type and kind, including any claims arising out of my participation in this event. I grant permission for the use of any photographs, videotapes, motion pictures or other recordings of this event for any purpose.

    Signature (required)_______                                                                         
      Parent or Guardian if under 18

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