
6th ANNUAL
5K & 10K RUN
1 MILE RUN/WALK
Saturday Sept. 11, 2010
Plattsburgh Oval, New York
Pre-Registration & Packet pickup : Friday, Sept. 10
4:00 - 7:00 pm Trinity Park, Plattsburgh, NY
Sept. 11 - Registration 8:00 am - Plattsburgh Oval, NY
5K Run - 9:00 am
10K Run - 9:05 am
1 Mile Run Walk - 9:00 am
______________________________
Last Name____________________________First Name______________________________
City___________________________State_________Zip__________Phone_______________
email______________________________________(will only be used to email registration)
(Check all that applies)
Sex: M ____ F ____ Youth: ____ Senior: ____ Age as of Sept. 11, 2010_________
5K: ____ 10K: ____ 1 Mile Run/Walk: ____
15 & Under: ___16 – 19:____20 - 29:____30 –39:___40 – 49:___
50 – 59:___60 & Over: ___
T-Shirt: Adult S:_____ M:_____ L:_____ XL:_____ XXL_______
Youth: XS:_____S:_____ M:_____ L:_____
Registration: 5K & 10K: $20.00
Includes T-Shirt, participation medal, 1st, 2nd, 3rd place medals.
1 Mile Run/Walk: $15.00
Includes T-Shirt, and ribbon
Make checks out to BOPCC ( Battle of Plattsburgh Commemoration Celebration)
Mail: Cannonballfunrun, 94 Bradford Rd., Plattsburgh, NY 12901
email: cannonballfunrun@gmail.com
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WAIVER OF LIABILITY: In consideration of your accepting this entry, I the undersigned, intended to be legally bound, for myself, my family, my heirs, executors, & administrators, forever waive, release & discharge any & all rights & claims for damages & causes of suit or action, known or unknown, that I have against the Battle of Plattsburgh Commemoration Celebration, the Battle of Plattsburgh Association, the City of Plattsburgh, all race committee persons, officials & volunteers, & all sponsors of the Cannonball Fun Run & related events & their officers, directors, employee, agents, & representatives, successors, & assigns, for any & all injuries suffered by me in this event. Latest that I am physically fit, am aware of the dangers & precautions that must be taken when running in warm or cold conditions, & have sufficiently trained for the completion of this event. I also agree to abide by any decisions of an appointed medical official relative to my ability to safely continue or complete the run. I further assume and will pay my own medical & emergency expenses in the event of an accident, illness, or other incapacity regardless of whether I have authorized such expense. I have read this weaver carefully & understand it.
Signature:_____________________________________________________