Join us for Plattsburgh's Race against time!!
When: Saturday October 26, 2013
Where: The Crete Civic Center, Plattsburgh NY
All proceeds to benefit ETC Housing Corporation
Registration from 10:00am-11:45am
The event begins at 12pm and you can participate in one of the races:
- The Short Course (Between 3 and 3.25 miles)
- The Long Course (Between 6.25 and 6.5 miles
The race is a walker/runner friendly race in which participants predict the times in which they will complete the distances. The race winners will be those that finish closest to their predicted time. Costumes are encouraged, and prizes will be given in costume categories.
ETC Housing Corporation is a United Way Agency
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - REGISTRATION FORM- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Send checks or money order payable to: ETC Housing Corporation, P.O. Box 2708, Plattsburgh NY 12901
I know that participating in a distance run/walk event is potentially hazardous activity. I will not enter and participate unless I am medically able and properly trained. I assume all risks from participating in this event and its related activities including, but not limited to: falls; contact with other participants; effects of weather; traffic and road conditions; all such risks being known and appreciated by me. Having read this waiver and release and knowing these facts and in consideration of your accepting my entry fee and participation, I, for myself and anyone entitled to act on my behalf, waive and release ETC Housing Corporation, race officials, volunteers, sponsors and their respective affiliates, subsidiaries, principals, directors, agents, officers, employees or contractors of and from all claims, liabilities or causes of action of any kind arising out of my participation in this event or its related activities which I or my successors, assigns or heirs may ever have now or in the future against any of them. This release and waiver extends to all claims of every kind and nature whatsoever. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any lawful purpose. Applications for minors will be accepted only with a parent’s signature but must be 16 years or older to participate in the long course. In the event that I require special attention, I hereby give consent to authorize medical personnel to provide such medical care as deemed necessary. I understand that race organizers have the right to refuse participation for any reason. I understand that all entry fees are non-refundable and that there are no exceptions to this policy.
First Name:_____________________ Last Name:_______________________________
Date of Birth:__ __/__ __/__ __ __ __ Gender(Please Circle): M F
Course to be completed (Please check one):________Long course_______Short course
Time predicted for Course Completion (Please remember the course needs to be completed in the 2 hour allotted timeframe):
# of hours_________ # of minutes__________ # of seconds____________
Email: __________________________ T-Shirt Size (Please Circle One: S M L XL XXL
City: _____________________________ State: _________________ Zip:_____________
Emergency Contact Info: Name______________________ Phone: __________________
Signature: ____________________________________ Date: ______________________
Parent’s Signature (if under 18) ________________________ Date: _________________