Turkey Hill Country Classic

15th Annual Country Classic

May 3, 2014

5 km or 10 km Run Registration Form

Event: 5 km Runner   5 km Walker   10km     10km Relay  

Name:     _________________________________

Address:

                  ________________________________________

                  ________________________________________

Phone:     _________________________________

Email:      _________________________________

Gender: Male   Female

Age at time of race:      ________________

T-Shirt Size:      ________________


Emergency Contact:

Name:     _________________________________

Phone:     _________________________________

The registration fee for either race is $12 before April 30 or $15 after.

Make checks payable to Manor Township, and send payment & registration form to:
THCC
950 West Fairway Drive
Lancaster, PA  17603

Waiver and Release: Please read prior to signing race entry form.
I hereby request permission to participate in the Turkey Hill Country Classic. In consideration of the entry being accepted, I, intending to be legally bound for myself, my heirs, executors, administrators, waive and release any and all rights I have against the organization holding this event, its agents, representatives, sponsors, successors and assigns for any and all injuries suffered by me or damages out of, or related to, the race. I verify that I am physically fit and have trained sufficiently for this race. I grant permission to use photos of me and release my name for any and all race purposes. All of the forgoing has been read by the undersigned and voluntarily been signed.

Signature:  __________________________     Date: ____________