|
|
| Your Name: |
| Address: |
| Town/State & Zip Code |
| Telephone Number: |
| E-Mail Address: |
| Sex Age Weight For Weight Divisions |
| How Much Money Have You Enclosed: |
|
|
| _______________________________________________________________________ | |||
|
|||
| Signature of parent if under
18 In consideration of my acceptance of this entry I intend to be legally bound, hereby for myself, my heirs, executors and administrators waive and release any and all claims for personal damage I may have against the city of Somerville where the event is being held in, organizers, B.A. Event Promotions, Somerville Striders Athletic Club, Paul Collyer, all sponsors of the race and I attest and verify that I am physically fit and sufficiently trained for this event on 3/15/09. I also understand that there are no refunds regardless of the circumstances. I also understand that I must be present to receive any merchandise I have ordered - WE WILL NOT MAIL OUT |
Please address all
checks and money orders to B.A. Event Promotions
and mail to
B.A. Event Promotions 224 1/2 Chandler Street #1
Worcester, Massachusetts 01609
(617) 625-2140