Registration

Fields in B L U E are required.

First Name:
Last Name:
Sex:
M F
Birth Date: (mm/dd/yyyy)
Age on Day of Race:
Address 1:
Address 2:
Town:
State:
Zip:
Phone:
Email:
T-Shirt Size (check one):
S M L XL

Release Statement

I know that a road race is a potentially hazardous activity. I should not enter unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely compete in or complete the race. I assume all risks associated with running in this event including, for not limited to, falls, contact with other participants, the effects of weather, including high heat and humidity, traffic and road conditions, all such risks being known and appreciated. Having read this waiver and knowing these facts and in consideration of the acceptance of this entry, I, for myself and anyone entitled to act on my behalf, hereby waive and release the organizers and directors of this race, the United States Army Corps of Engineers, the Thetford Volunteer Fire Department, the Town of Thetford, the Thetford FASTSquad, and any and all sponsors of this race, their representatives and successors from any and all claims and liabilities of any kind which may arise out of participation in this event even though that liability may arise out of the negligence or carelessness on the part of the persons or organizations named in this waiver.

 
Signature of Participant (or legal guardian if under 18 years of age) Date (mm/dd/yyyy)