Mill Cities Relay Application

MILL CITIES RELAY APPLICATION

Team Captains must fill out completely by typing information in fields, then printing out and mail to:
Mill Cities Relay, 6 Perkins Court, Haverhill, MA 01832 - ENTRY-FEE: $60 for 5-person teams and $40 for 3-person teams Entry closes on Novermber 25 - no entries will be accepted after this date. Checks should be made payable to Mill Cities Relay.
THERE IS NO RACE DAY ENTRY.

  First Name Last Name        
      Address        
          City   State  Zip Code
        Phone 
                   
                    Highlight your club's name
                  

  Team Name (be creative): 
  You must select ONE: Male Female Coed 
  You must select your division:Open Master  Seniors Vets

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 run. I assume all risks associated with running in the event including, but not limited to: falls, contact with other participants, the effects of weather, including high heat and or humidity, 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 all sponsors, the hosting running clubs, the Town of Nashua, Hudson, Tyngsboro, Lowell, Dracut, Methuen, and Lawrence their representatives, successors from all claims or liabilities of any kind arising out of my participation in this event even though the liability may arise out of negligence or carelessness on the part of the personnamed in the 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.

MANDITORY you must fill-in the first and last name of each team member