Registration Form for the 2017 Road Race and Fun Run

Please complete an application for each runner
Bring cash/check payment to race registration. Make checks out to: The Community School
The first 30 pre-race day registrants get free Community School bumper stickers!
*Healthy, homemade food will be available for purchase on race day.*

Saturday May, 6
9:00am: Registration
9:30am: Fun Run
10:00am: 4.1 Mile Road Race

Directions to race: From Main Street Somesville, turn onto Pretty Marsh Road. Pond’s End will be on the Left as you drive toward Pretty Marsh.

Name

First Name

Last Name

Gender

Age

Email Address

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact

First Name

Last Name

Emergency Contact Phone

(###)

###

####

Which race are you registering for?

4.1 Mile Road Race - $20

1 Mile Fun Run - $3

Waiver - Read and Write Name as Signature (Parent if under 18)

Waiver: I know that running a road race is a potentially dangerous 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 this event including but not limited to: falls, contact with other runners, the effects of weather, traffic and 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 accepting my entry, I waive and release The Community School and the Town of Mount Desert for all claims of any kind arising out of my participation in this event.