5K - 11:00 A.M. Sunday March 16, 2008
Davis Square Somerville, Massachusetts

Your Name:

Address:

Town/State & Zip Code

Telephone #:                                                     E-Mail Address:

Age:              Sex:         Weight:                 T-Shirt Size:

PLEASE CIRCLE:               RUNNER                  WALKER

I want to buy some merchandise:  Item-                                          Size-

I have included with my application the following amount of funds for this event: $

IRISH PUB TEAM  (name of your favorite pub and location):

Yes I was born in Republic of  Ireland or Northern Ireland:   Village, Town or City of-                                                   Co.-

I am (circle)   1st -  2nd-  3rd, 4th or  5th  Generation Irish:            Village, Town or City of-                                           Co.-

WAIVER: 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 or town that the event is being held in, organizers, Somerville Track PAC, B.A. Event Promotions ,all sponsors of the race, and I attest and verify that I am physically fit and sufficiently trained for this event on March 16, 2008. _ I also understand that there are no refunds regardless of the circumstances and that I must pick up all merchandise  I have ordered.

__________________________________________________________________________________________________

Signature/Signature of parent if under 18   Date

Please address all checks and money orders to B.A. Event Promotions  224 1/2 Chandler Street #2, Worcester, Massachusetts 01609