For Club Connecticut 2010 Races
To print this form, use PRINT option 


Name__________________________________________________________


Sex_______  Birth Date______/______/______
(Don't put today's date unless you were born yesterday)



Phone______________________ E-Mail Address__________________________________



Address_____________________________________________________________________



City, State, Zip____________________________________________________________



T-Shirt Size: S ____  M ____ L ____ XL ____

To enter, check the appropriate box and enter the amount on the right:
_____
 Spring Equinox 8 km
Sunday, March 21, 3 pm, New Canaan

$12 pre/ $15 post
156 Fillow St.
Norwalk, CT 06850

$_____

_____
 Boston Blowout 30 km
Sunday, March 28, 7:30 am, Fairfield

$15 pre/$17 post
Boston Blowout
156 Fillow St.
Norwalk, CT 06850

$_____

____
 The Bunny Boogie 3 Mile
Saturday, April 3, 9 a.m., Darien

$12 pre/ $15 post/ $5 kids
156 Fillow St.
Norwalk, CT 06850

$_____

_____
 Summer Concert Cross Country Series
7 pm Tuesdays beginning June 1,
Waveny Park, New Canaan

$2 post entry only beginning 6:30 pm.

Post Enter
Only

_____
 Four on the Fifth
4 Miles, TBD, 9 a.m., New Canaan

$12 pre/$15 post
156 Fillow St.
Norwalk, CT 06850

$_____

____
 Fall Distance Frolic 30 km
Sunday, September 19, 7:25 am, Stratford

$15 pre/$17 post
Fall Distance Frolic
156 Fillow St.
Norwalk, CT 06850

$_____

____
 The Great Train Race 6.816 Mile (note new date)
Sunday, October 24, 8:25 am, New Canaan to Wilton

$12 pre/$15 post
156 Fillow St.
Norwalk, CT 06850

$______

____
 Police Pumpkin Chase 5 km
Sunday, October 24, 3 pm, New Canaan Pool

$12 pre/$15 post
156 Fillow St.
Norwalk, CT 06850

$______
   

 

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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