|
Or, Please make check payable and mail to:
 Tewksbury
First Aid & Rescue Squad
Attn: Paul Zanelli
PO Box 381
Oldwick, NJ 08858
Last Name:________________
First Name: ________________
Street Address: ____________
Town/State/Zip:______________
Phone: ___________________
Age on Race Day: ______
Date of Birth: __________________
Sex: ___Male ___Female
Shirt Size: ___S
___M ___L ___XL ___XXL
Which Run? ___5 Mile ($20 if
Postmarked by 10/5; $25 After)
___1 Mile Fun Run ($15 if Postmarked by 10/5; $20 After)
Tewksbury Resident? ____Y
____N
I, the undersigned, know that running is a
potentially hazardous activity. I should not enter unless I am medically able &
properly trained. Having read this waiver, and knowing these facts, and in
consideration of my entry, I for myself and anyone entitled to act on my behalf,
waive and release the Tewksbury First Aid & sponsors, representatives, &
successors from all claims or liabilities of any kind arising out of my
participation in this event though that liability may arise out of negligence or
carelessness on the part of the persons named in this waiver.
Signed:
_______________________ Date: _____/_____/_____
(by guardian if under 18)
|
