Light the Night 2017
5K
3K •
Light the Night 2017
ftock!*«d
Race #
All proceeds benefit the local Special Olympics Race Day Registration Form 3K & 5K Run or Walk The first 20 registered get free T-shirts! T-shirt for $10 on day of the race.
S H t t T Bptmztmt OiijmpHrm
Can purchase a
First Name: Address:
Phone Number: Email:
T-shirt Size:
Registration begins at 6 pm Race starts a 7 pm Location: Trackside Station 4 Union St., Rockland, Maine
Liability Waiver
Last Name:
Gender: Male
Race Date: September 17, 2017
Female
Age on day of race:
S M L XL 2XL
$23 Preregistration or $25 day of registration. Students 18 and under are $15. Make checks payable to Rockland Kiwanis. If preregistering mail form and check to Rockland Kiwanis, PO Box 285, Rockland ME 04841 Questions: Contact Marjorie Kinney, phone 207-354-9591 or email: [email protected]
I understand that running a road race is potentially a hazardous activity. I further understand that I should not enter a road race unless I am medically able and properly trained. I agree by any decision of a race official relative to my ability to safely complete the run. I assume all risks associated with running this event including, but not limited to, falls, contact with other participants, the effects of the weather, including high/heat or humidity, traffic conditions of the road, all such risks being understood and appreciated by me. I having read the wavier and understand these facts, and in consideration of your accepting my entry, I for myself and anyone entitled to act on my behalf, wave and release the Kiwanis club of Rockland and all volunteers, sponsors, vendors, their representatives and successors from any claims or liabilities or causes of action of any kind arising out of my participation in this event. All participants are to wear glow sticks or other illumination. Some illumination will be available for sale at the race. Signature^ Parent if under 18:
Date
3K •
Light the Night 2017
ftock!*«d
Race #
All proceeds benefit the local Special Olympics Race Day Registration Form 3K & 5K Run or Walk The first 20 registered get free T-shirts! T-shirt for $10 on day of the race.
S H t t T Bptmztmt OiijmpHrm
Can purchase a
First Name: Address:
Phone Number: Email:
T-shirt Size:
Registration begins at 6 pm Race starts a 7 pm Location: Trackside Station 4 Union St., Rockland, Maine
Liability Waiver
Last Name:
Gender: Male
Race Date: September 17, 2017
Female
Age on day of race:
S M L XL 2XL
$23 Preregistration or $25 day of registration. Students 18 and under are $15. Make checks payable to Rockland Kiwanis. If preregistering mail form and check to Rockland Kiwanis, PO Box 285, Rockland ME 04841 Questions: Contact Marjorie Kinney, phone 207-354-9591 or email: [email protected]
I understand that running a road race is potentially a hazardous activity. I further understand that I should not enter a road race unless I am medically able and properly trained. I agree by any decision of a race official relative to my ability to safely complete the run. I assume all risks associated with running this event including, but not limited to, falls, contact with other participants, the effects of the weather, including high/heat or humidity, traffic conditions of the road, all such risks being understood and appreciated by me. I having read the wavier and understand these facts, and in consideration of your accepting my entry, I for myself and anyone entitled to act on my behalf, wave and release the Kiwanis club of Rockland and all volunteers, sponsors, vendors, their representatives and successors from any claims or liabilities or causes of action of any kind arising out of my participation in this event. All participants are to wear glow sticks or other illumination. Some illumination will be available for sale at the race. Signature^ Parent if under 18:
Date
