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Last Name

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Run or Walk

Male Female Run Walk

Age on April 17 2010

 

Waiver: In consideration of my entry being accepted, and the grant of permission for participation in the above named race, I for myself, my heirs, executors, administrators, and assigns, do hereby and with full knowledge of the consequences for this act, waive and release any and all rights and claims for personal injury or other loss or damage which may arise from said entry and/or participation in this race, against any and all sponsors, backers, supporters, and contributors to this race, including but not limited to the town of Leverett, the landowners upon whose property the course is laid, the race directors, organizers, administrators, officials, and volunteers, and the business sponsors and promoters of this race. USATF New England and all of its officers and/or representatives shall be free from any liabilities or claims for damages arising by reason of injuries to anyone during the conduct of this event. To contact USATF-NE office call 617-566-7600

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