23rd Annual Christopher Martins
Christmas Run for Children
5K Race, Sunday, December 9, 2007, 10 a.m.
Register early!--Toy can be dropped off on race day
Entry Form
(Can be Duplicated)
| First Name_______________________ Last Name______________________________ | ||
| Address_________________________City_________________State_____Zip________ | ||
| Day Phone__(___)___________ Male __ Female __ Age ___ Date of Birth ___/___/___ | ||
| Wheelchair/Disabled Athlete _____ E-mail ______________________________________ | ||
| Waiver: I know that participating in a road race is a potentially hazardous activity. I will not enter and participate unless I am medically able and properly trained. I assume all risks from participating in this event and its related activities, including but not limited to, falls, contact with other participants, effects of the weather (including cold temperatures, ice and winds), traffic, and other conditions of the road, all such risks being known and appreciated by me. Having read this waiver and release and knowing these facts and in consideration of your accepting my entry fee and participation, I, for myself and anyone entitled to act on my behalf waive and release the AT&T, City of New Haven, race officials, Christopher Martins Restaurant, John Bysiewicz, JB Sports LLC, volunteers and all sponsors and their respective affiliates, subsidiaries, principals, directors, agents, officers, employees of contractors of from all claims or liabilities of any kind arising out of my participation in this event or its related activities which I or my successors, assigns or heirs may ever have nor or in the future against any of them. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any lawful purpose. | ||
| ___________________________________________________________________________ Signature of Athlete (Parent's signature if under 18) Date |
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| Please Check below | ||
| Application fee (t-shirt not included): |
$12 pre registration ___ |
|
| Long sleeve T-shirt $10 |
T-shirt size S__ M__ L__ XL ___ |
|
| Register early raceday entry fee $15 | Total Paid ______ | |
| Make checks payable to: Christopher Martins Christmas Run for Children | ||
| Send to: Christopher Martins, 860 State Street, New Haven, CT 06511 | ||