GREEN MILE ROAD RACE

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					                   GREEN MILE ROAD RACE
6PM JUNE 21ST DURING 3RD THURSDAY ….ONE MILE USATF CERTIFIED COURSE IN FRONT OF THE THIRD
THURSDAY CROWDS REGITRATION AT BERKSHIRE RUNNING CENTER 42 SUMMER ST. RACE BEGINS AND
                      ENDS AT BERKSHIRE BANK PARK SQ PITTSFIELD, MA.




FIRST NAME _________________ LAST___________________________ AGE __

STREET ________________________________ CITY _________________

STATE_____ ZIP___________PHONE___________________

EMAIL ADDRESS ________________________________________GENDER: M / F

Technical Race Shirt for the first 250 Men and Women Sizes Small                                         Medium
  Large    Extra Large

Registration fee $15 before June 17, $20 after June 17. Checks made payable to Berkshire Running Center, 42
Summer St Pittsfield, MA 01201 Proceeds to benefit Pittsfield Beautiful

Information contact Kent Lemme or Shiobbean Archey at 413-344-4472            www.berkshirerunningcenter.com

In consideration of the acceptance of this entry: myself, heirs, executors, and administrators, waive and release any
and all rights and claims for damages I may have against The Berkshire Running Center, all race sponsors, organizers,
volunteers, officials, USATF and the cities and towns participating for any and all injuries suffered by me while
competing in, and traveling to or from this event. I attest that I am physically fit and sufficiently trained to compete in
this event. I also willingly release my image for photography, video, and film cameras which may chronicle this event

RUNNER’S SIGNATURE___________________________

(Signature of Parent or Guardian if athlete under 18)

				
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