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Name__________________________________________________________


Age_____ Birth Date______/______/______ Sex_____


Phone______________________ E-Mail Address_________________________________


Address__________________________________________________________________


City, State, Zip______________________________________________________________


Longsleeve Mock-T Shirt Size:  S ____  M ____ L ____ XL ____ ($12, will be delivered at 10 and 15 km)


To enter, check the appropriate box and enter the amount on the right:

_____
 Boston Buildup Winter Series
10, 15, 20 & 25 km races below		 Boston Buildup XXXIV
156 Fillow St.
Norwalk, CT 06850

$43 pre

$48 post

 _____  Boston Buildup 10 km
Sunday, January 8, 10 am, Rowayton		 Boston Buildup XXXIV
156 Fillow St.
Norwalk, CT 06850

 

$18

_____
 Boston Buildup 15 km
Sunday, January 22, 9 am, Ridgefield		 Boston Buildup XXXIV
156 Fillow St.
Norwalk, CT 06850

$18*

_____
 Boston Buildup 20 km
Sunday, February 12, 9 am, Southport		 Boston Buildup XXXIV
156 Fillow St.
Norwalk, CT 06850

$18*

_____
 Boston Buildup 25 km
Sunday, March 4, 8:30 am, Silvermine		 Boston Buildup XXXIV
156 Fillow St.
Norwalk, CT 06850

$18*

_____
 Boston Blowout 30 km
(Not part of Series scoring)
Sunday, March 25, 7:30 am, Fairfield		 $15 pre/$17 post
Boston Blowout
156 Fillow St.
Norwalk, CT 06850

$_____

_____
 Running Times Subscription
All entrants will receive a 1-year (10 issues) subscription to Running Times, a $10 value.
You must check this box to complete your registration.
Enter "NO" if you do not want to receive it. 		   

* Deduct $3 if these are your second or third races of the Series.

 

I know that running in a race 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 this event including, but not limited to, falls, contact with other participants, the effects of the weather, including high heat and/or humidity, traffic and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my application, I for myself and anyone entitled to act on my behalf, waive and release the race organizers, the cities and towns in which this event is held, and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings or any other record of this event for any legitimate purpose.

 


Signature________________________________________________________________


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