4th of July Road Race Registration

TUESDAY, JULY 4, 2017

WHEN: 9:00 AM

WHERE: Chepachet Union Church, 1138 Putnam Pike, Chepachet, RI

There are four races: a 5.5 mile race, a 1.75 mile race, a 1 mile race for children 8-12 years old, and a .5 mile race for children 7 years old and under. There is a registration fee, although Glocester residents are charged less than out-of-towners, and Glocester youth run for free. Glocester residents: $10.00 for adults; free for children. Out of town residents: $20.00 for adults; $10.00 for children. All participants receive a free T-shirt while supplies last.

Registration fees may be paid on the day of the race.


Name

 

Town

State

Age (as of this race)

M/F

 

 

By submitting this form, in consideration of accepting my entry, I intend to be legally bound, hereby waive and release any and all  rights and claims for losses and damages that I may have against the Town of Glocester and its representatives; the Glocester Recreation Commission and its members; all volunteer medical and personnel  for any injuries that may be received from participation in the Glocester 4th of July Road Race sponsored by the Glocester Recreation Department. This waiver of liability and assumption of risk is based  upon Rhode Island Statute 7-6-9 entitled Exemption From Liability. I further understand that the above applies if this form is submitted for a person under the age of 18.

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