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5K Registration Form

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Name

 


Address

 


City, State and Zip Code

 

Phone                                                          E-mail

 

Required information for awards/prizes

Gender (circle one)                   Male            Female

Date of birth ______________ Age (on race day)___________

 

T-shirt size (circle one)    CHILDREN'S SIZES    S        M       L

                                      ADULT SIZES           S        M       L        XL

 

 

 

 

 

 

 

 

 

 

 


Registration Fee  (make checks payable to CAMPA "B to B Run" on the check memo line)

$ 20.00    by October 5, 2007

$ 25.00    after October 5 or on day of race

On-line registration available at Active.com

 

Mail completed entry form and check to:

          Bridge to Bridge Run, 1 Raritan Drive, Califon, NJ  07830

          For more information, please call: 908-832-6474

 

Waiver:

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 race.  I assume all risks associated with running in this event including, but not limited to: falls, contact with other participants, the effects of the weather, including high heat and/or humidity, traffic and the conditions of the road or any running surface, 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 the BRIDGE TO BRIDGE FUN RUN, the BOROUGH OF CALIFON, and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event though that liability may arise out of negligence or carelessness on the part of the persons named in this 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.

 

Participant signature_________________________________________Date________________

(Parent or guardian must sign if participant is under 18 years of age)

 

Parent/guardian signature         ____________________________________Date________________