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Sunday, September 28, 2008 |
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| Make checks payable to "Tommy Fund" | Mail to: |
Tommy Fund Family Fun Day c/o Yale-New Haven Children's Hospital 20 York Street New Haven, CT 06504 |
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Postmark deadline for mail entries:
September 23, 2008. Non-refundable entry fee: Adults $15 until
9/26/08 and $20 on event day. Kids 10 years and under $8 until 9/26/07
and $10 on event day. |
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| Please Print: | |||
| Last Name________________________ First Name _______________________ | |||
| Address __________________________________________________________ | |||
| City ___________________________ State ____________________ Zip_______________ | |||
| Phone _____________ Age (on race day) _______ Birthdate __________ | |||
| Sex: Male ___ Female___ T-shirt size: M___ L___ XL___ | |||
| Team Name __________________________________________ | |||
| School (Students Only) _______________________________________ | |||
| Long sleeve t-shirts for the first 800 registered. | |||
| Please accept an additional donation of $____ to The Tommy Fund. | |||
| Waiver: In consideration for my participation in the Tommy Fund Family Day ("Event"), I personally assume all risks, whether foreseen or unforeseen, in connection with the Event, of any harm, injury or damage that may befall me as a participant. I release and hold harmless The Tommy Fund Inc., Yale-New Haven Hospital, Yale University, City of New Haven, JB Sports LLC, Run for the Kids, and any organizers and/or sponsors of the Event (collectively referred to as "Released Parties") from any claim or lawsuit for personal injury, property damage or wrongful death, by me, my family, estate, heirs or assigns, arising out of participation in the Event, including both claims arising during the activity and after I complete the activity and including claims based on negligence of other participants or the Released Parties, whether active or passive. I represent that no known physical or health limitations prevent me from safely participating in this Event. I agree to allow my image to be used in any and all published materials and websites that promote The Tommy Fund, Inc. Application for minors under 18 will be accepted only with parent's signature. | |||
| __________________________________________________ | _______________________________________________ | ||
| Signature of Athlete | Signature of Parent (if under 18) | ||