APPLICATION

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Groton Town Forest Trail Runs - October 15, 2017

Please fill out one application for each runner if submitting as a family (children + parents/guardians).

Please check one:

9.5 mile run [ ]    (12:30 p.m.)                      3.4 mile run [ ]   (12:40 p.m.)

Please print the information below:

Name____________________________Age____Date of Birth__________M [ ]    F [ ]

Address___________________________Emergency Phone__________________

City/Town_________________________________State__________ZIP_____________

e-mail_________________________

Please Read and Sign:

I, the undersigned, accept full responsibility for myself and for any injuries that I may incur during the Groton Town Forest Trail Run. I have read the entire Home Page and I fully understand that participating in this event may be dangerous to my health. Sprained ankles, cuts, bruises, and broken bones are real possibilities. I hereby for myself, heirs, executors, and assigns, waive and release any and all rights and claims for any and all injuries suffered by me, however incurred or sustained, against the organizers, landowners, the Town of Groton, the West Groton Water District, the Squannacook River Runners, or any volunteer or race helper. I attest that I am physically fit, I understand the difficulties and hazards of trail running, I have trained sufficiently for the completion of this event, and my actions, mishaps, and medical costs are accountable to no one but myself.

Signed_____________________________ Date_____________
(Parent or Guardian if under 18)
 

  ENTRY FEES (Please note that the fee is non-refundable and bib numbers are non-transferable.):
[  ] $15 Individual, before 7/31/2017          [   ] $20 Individual 8/1/2017 to 10/7/2017        [   ] $25 after 10/7 and Race Day

[  ] $40 Family, before 7/31/2017               [   ] $50 Family 7/31/2017 to 10/7/2017           [   ] $60 after 10/7 and Race Day

[  ] $5 Race Directors (MUST PRE-REGISTER by mail or e-mail, and include name of race)

Please make checks payable to: Squannacook River Runners

 

Mail entries to: Groton Town Forest Trail FRace CO: Rick Coveno, 73 Pleasant St., Groton, MA 01450-1039