Run from Fitness Concepts to the Gardner Ale House
for a Beer at the finish, 225 Commemorative Beer Glass,
FREE Tek Running Shirt, & Raffle Tickets
to all Runners and Walkers!
5K Run/Walk, Friday, Sept 24, 2010
Entry Fees: $15 PreRegistrant (BEFORE July 15, 2010) / $20 Registrant (AFTER July 15, 2010)
Mail Entry Form and Check To:
Fitness Concepts Health Club | Attn: Road Race | 696 West Broadway, Gardner MA 01440
Name: _____________________________________________________________________
Address: ___________________________________________________________________
City/State/Zip: _______________________________________________________________
Phone: _____________________________________________________________________
Email: _____________________________________________________________________
Please Check: ___Walker ___Runner
Circle T-Shirt Size: ___S ___M ___L ___XL
Fitness Concepts Health Club - Waiver of Responsibility
I hereby for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I may have against the sponsors, coordinating groups and the individuals associates with this event, their representatives, successors and assigns, and will hold them harmless for any and all injuries suffered in connection with this event. I attest that I am physically fit to compete in the Fitness Concepts Road Race, Further, I grant full permission to any and all of the foregoing to use photographs, video tapes, motion pictures, recordings and/or any other records of this event of myself along or with others for any legitimate purpose. I understand that pacing bicycles, skateboards, baby joggers (or strollers), roller skates (or blades), and animals are not allowed in the race.
Signature____________________________________________Date_________________________
Prizes Awarded ~ 1st & 2nd Place ~ Both Male & Female