Yankee Homecoming Roadrace

1997 Yankee Homecoming Entry Form
Please Print Clearly
Last Name
First Name
Age on Race Day
Sex
Address
City
State
Zip Code

RACE ENTERED (check one)
10 Mile _________ $12.00 entery fee / $15.00 on race day
3 Mile _________ $7.00 entery fee / $9.00 on race day
UASTF-NE Entry (Required for USATF entry only.)

Team Name ____________________ Club number __________ USATF # __________

Corporate Team Name (3 mile race only) __________________________

Make checks out to the Newburyport Lions

READ WAIVER BEFORE SIGNING
In consideration of my acceptance of this entry, I intend to be leagally bound for myself, my heirs, my executors and administrators, waive and release the USATF-NE and its offocers, Newburyport Lions Club, the City of Newburyport, all sponsors, race workers, the Newburyport High School, and all Lions Clubs from rights and claims for damage, injury, and illness I may have from this event. I attest that I have trained for this race. I realize the course is not shut down from traffic. Certify my compliance with my signature.

X____________________________________________________
Signature of Participant (or signature or parent/guardian if under 18 years of age)

MAIL ENTRIES TO: PO Box 366, Newburyport, MA 01950

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