Make checks payable to: RYTO
Mail to: RYTO, 3 Foster Street, Haverhill, MA 01832

Entry-Fees:

First Name__________________________________ Last Name ___________________________________ 

Age (on race day) ____________________________ Gender ____________________
		
			Check One:   1K_____           5K_____            15K______
                        
Clydesdale (male over 200lbs.) ______     Filly (female over 150lbs.) ______      Wheelchair ______

Team/Club Name (if any)________________________________________________________________ 

Address___________________________________________________ 

City_______________________________________________________ State_______ Zip_______________ 

Email Address __________________________________Phone No.________________________________ 

Waiver (read before signing)

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 a race official relative to my ability to safely complete the run. I assume all risks associated with running in the event including, but not limited to: falls, contact with other participants, the effects of weather, including high heat and or humidity, traffic, and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release all sponsors, the Greater Lowell Road Runners, the Towns of Tewksbury and Andover their representatives, successors from all claims or liabilities of any kind arising out of my participation in this event even though the liability may arise out of negligence or carelessness on the part of the person named in the waiver. 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.

Signature:________________________________
(parent or guardian if under 18)