RacePacket Summer Strides **Grand Prix Race #6**
racePacket - Mail-in Entry Form
Sunday, August 6, 2017

Make checks payable to "RacePacket, Inc." and mail to PO Box 25094, Arlington, VA 22202
          First Name: 
           Last Name: 
             Address: 
                City: 
               State:           Zip: 
               Phone: 
              E-Mail: 
       Date of Birth:       Age on Sunday, August 6, 2017: 
              Gender: Male Female
           Entry Fee: $30 
Fee On or After 2016-07-28:
                      $35 
          Shirt Size: S M L XL 
               Event: 5K Run 

Waiver Must Be Read and Signed Before Mailing:

In consideration of my application, I hereby, for myself, my heirs and executors, waive release and forever discharge any and all rights and claims for damages which I may have or may hereafter accrue to me against the organizers and sponsors of the Summer Strides 5K, RacePacket, Inc, RRCA, Washington Running Club, Georgetown Running Co., and all race sponsors and their representatives, successors and assigns, for any and all injuries suffered by me in said event. I attest and verify that I am physically fit and have sufficiently trained for the competition of this race, and my physical condition has been verified by a licensed medical doctor. Further, I hereby grant full permission to any and all of the foregoing to use my name, photographs, videotapes, motion pictures, recordings or any other record of this event for any legitimate purpose without compensation or reenumeration.


_______________________________ _____________ _____________________________________ Signature Date Parent's Signature if under 18

From www.racePacket.com, Thanks for your support.



All blanks must be filled in.

Note that online registration on RacePacket is available for this race.


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