Entry form for the George Wodicka 
Hook Half Marathon/Hope Run or Walk
April 22, 2007

Mail to: RRR, PO Box 435, Congers, New York 10920
 

__13.1 mile race   __ 5K Race   __ 5K Walk    __ 5K Wheelchair Division

_______________________________     Corporate Team Name (if participating)

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _ _ _    _
Last name                                        First Name                       M.I.

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _      Official Use Only _____
Street Address
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _    _ _   _ _ _ _ _     _ _ _ - _ _ _ -_ _ _ _
City                                                 St     Zip              Phone

Email address _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Shirt Size _M _L _XL    Born _ _ /_ _ /_ _   Age on race day _ _   M_ F_

Amount enclosed __$18 Pre-Entry   $15 RRR Pre-Entry (____M'ship #)  __ $20 Race Day

_____    I am enclosing an additional $20 for a one year membership to the RRR

WAIVER MUST BE SIGNED

I know that running and volunteering to work in club races are potentially hazardous activities 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 the risks associated with running and volunteering to work in club races including, but not limited to, falls, contact with other participants, the effects of the weather, including high heat and/or humidity, the conditions of the road and traffic on the course, all such risks being known and appreciated by me. Having read this waiver and knowing these facts, and in consideration of your acceptance of my application for memmbership, I for myself and anyone entitled to act on my behalf,waive and release the Road Runners Club of America, the Palisades Interstate Park Commission,United Hospice of Rockland and all sponsors, their representatives and and successors from all claims or liabilities of any kind arising our of my participation in these club activities even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I understand that bicycles,skateboards,baby joggers,roller skates or blades,animals and radio headsets are not allowed in the race and I will abide by this guideline.