10 mile Boxing Day Run December 26, 2008 11am start by hcj


									               10 mile Boxing Day Run, December 26, 2010
                  First Name___________________________________________________

                  Last Name___________________________________________________
                                                                                 Age on
                  Sex _______ Birth Date M_____D_____Y______                     Race Day______


                  City / Town __________________________________________________

                  Prov / State ______________ Postal / Zip ______________________

                  E mail _______________________________________________________

                  Running Club or Group _____________________________________

                  All prices include HST                                Dec.1-22
                   Run or Walk with mitts                              $50.85
                   Technical Shirt                                     $20
                   Embroidered Cotton Shirt                            $20
                 Race Day Registration Rate $60 Run or Walk with mitts

Shirt size  x small  small  medium  large  x large  xx large

                                  Release, Waiver and Indemnity
In consideration of your this entry, I hereby for myself, my heirs, executors and administrators, waive and release any and all
rights and claims I may have against the YMCA of Hamilton/Burlington, The Hamilton Harriers, The City of Hamilton, Michael
Lamont legal firm and all other sponsoring companies, their agents, representatives, successors, and assigns, from any and all
injuries, loss or damage to any person or property howsoever caused, that may be sustained by my competing in or traveling to
and from the Boxing Day 10 mile run. Pictures are taken throughout the event, they may be used in future Boxing Day 10 miler
promotion. I consent for use of my image. By submitting this entry I acknowledge having read, understood and agreed to the
above waiver, release and indemnity.
I warrant that I have trained to participate in, and complete this 10 mile event.

          Date                              Print Name of participant

          Signature of participant or guardian if participant is under 19 years of age

                                Mail entry to:        Hamilton Harriers
                                                      102 Elmore Drive            Mail by December 17th
              Hamilton, Ontario
              L8W 2B2
Make cheque payable to Hamilton Harriers

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