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Online Registration at Active.com
When : Saturday! October 17, 9:00 a.m. 5K Start
Where: Southampton Cultural Center
Cost: $25.00 Preregistered postmarked by Oct 11; $30.00 Day of Race
Raise $250 or more in Sponsorship Funds and win a prize. Details at www.time4teens.org
Mail completed application to: "Time For Teens, Inc." c/o Laraine Gordon, P.O. Box 552, Southampton NY 11969
Check in 8:00- 8:45am
Course: Flat and fast MAP
Awards: Top male and female overall and first three in each age group.
Age Groups: 14 and under, 15-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89
Where: Southampton Cultural Center, Agawam Park, Pond Lane, Southampton
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Mail completed Time 4 Teens 5K application and check payable to: "Time For Teens, Inc." c/o Laraine Gordon, P.O. Box 552, Southampton NY 11969
Your E-mail________________________________________
Phone #______________
Name___________________________[ ]M [ ] F;Birth Date__/__/__ Age race day_____
Address_______________________________City___________State_____Zip_______
Waiver: I know that a 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 run. 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, dehydration, traffic and the conditions of the road, 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 Village of Southampton; the East End Road and Trail Runners Club; all sponsors, Race Directors, their agents, servants and volunteers, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, and any other record of this event for any legitimate purpose. Roller Blades, Baby Joggers, Headphones, Animals are prohibited from participating in this race.
Please make checks payable to:
Signature_________________________________________(if under 18, signature of parent or legal guardian.)
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