Thanksgiving Morning, Thursday, November 26, 2009, 9:00 a.m.
After completing, Please print this form and mail to:
Y Run & Walk
Please include check or money order payable to Y Run & Walk
Entry Fees are non refundable.
Registration Form (all participants must fill out)
Last Name: First Name:
Address: City:
State: Zip: Phone (Day): (Eve.):
Date of Birth: Age: Sex (circle): M or F
Team or School (if applicable) _______ ______________________________
E-mail address_____ _______________________________________________
Fee (if not
collecting $100 or more in pledges):
Adults Kids (12 and under)
Now thru November 1 $18 $10
November 2 - 25 $20 $12
On Thanksgiving $25 $15
Make your tax deductible checks payable to:
Branford Rotary YMCA Run & Walk
____ Waived entry fee if enclosing check(s) for $100 or more to the
Soundview
YMCA, c/o JB Sports,
Waiver: I know that running a road race is
a potentially hazardous activity. I should not enter and run unless I am
medically able and properly trained. I also know that although police
protection will be provided, there will be traffic on the course route. I
assume the risk of running in traffic. I agree to abide by any
decision of any race official as to my ability to safely complete the run.
I also assume any and all other risks associated with running this event,
including but not limited to, falls, contact with other participants, effects
of the weather, including high temperatures and/or humidity, thunder and
lightning, 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 entry, I, for myself and anyone
entitled to act on my behalf waive and release the Soundview
YMCA, Branford Rotary, JB Sports, LLC,
Signature: _______________________________________________________
(parent or guardian if under 18)