June 18, 2017

Report 1 Downloads 112 Views
June 18, 2017 Until 2/23

2/24 – 5/03

5/03 – 6/12

6/13 – 6/17

5 Mile

$27

$29

$31

$33

Raceday 6/18 $37

2 Mile Health Walk 1 Mile Kids Fun Run

$16

$17

$18

$19

$22

$10

$12

$13

$15

$17

______ I qualify for complimentary entry for raising $200 or more for Connecticut Advocates for Parkinsons or ALS Foundation. 5 Mile Kids Fun Run 2 Mile Health Walk 1 Mile Kids Fun Run Stony Creek Brewery Celebration Total Checks payable to:

$_______ $_______ $_______ $_______ $_______

Branford Road Race 2 Buena Vista Road Branford, CT 06405

Last Name______________________________ First_________________________________ Address_____________________________________________________________________ City_________________________________ Age_______

Male_______

State_______

Female_______

Zip______________ Date of Birth:

/

/

Email_______________________________________________________________________ WAIVER: I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I agree to abide by any decision of any race official as to my ability to safely complete the run I assume all risks with running this event, including but not limited to, falls, contact with other participants, effects of the weather, including high temperatures and humidity, traffic and the conditions of the road, all such risks being known and appreciated by me. In consideration of your accepting my entry, I the undersigned, intending to be legally bound, here by myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I may have against the Branford Road Race and their representatives, successors and assigns Eastern Indian Neck Association, Inc., Hotchkiss Grove Association, Inc., H.D. Segur, Inc., Planet Fitness, Remax Alliance, Pasta Cosi Restaurant, Lynn’s Deli, The Sound, Chabaso Bakery, Sound Runner, Faxon Law Group, Connecticut Orthopedic Specialists, 99.1PLR, Southern CT Muscle & Joint Chiropractic, 66 North Main Street Massage, Shoreline Crossfit, John Bysiewicz, JB Sports LLC., The Branford Festival Committee, the Town of Branford, the Branford Road Race, race officials, volunteers, and all sponsors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. I know that dogs, bicycles, in-line skates, and baby joggers & strollers are not allowed on the course.

Signature_______________________________________________________Date _____________ Parent/guardian must sign if competitor is under 18 years of age.

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