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-Do not mail out after 3/8/12- |
| Name: |
| Address: |
| Town, State & Zip Code: |
| Telephone: E-Mail Address: |
| Sex: Age on race day: T-shirt size: Weight for Weight Divisions (optional): |
| Emergency Contact Name: Emergency Contact Telephone: |
| Favorite Irish Pub (choose one): The Burren Joshua Tree Olde Magoun Saloon |
| On the Hill Tavern The Pub Sligo Pub Other _________________________ |
| Family is from Ireland Generation (e.g., native, 1st, 2nd, etc.): |
| Town/County: Republic or Northern Ireland |
| Amount enclosed (race fee $32.00): |
__________________________________________________________________________________ |
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| In consideration of my acceptance of this entry I intend to be legally bound, hereby for myself, my heirs, executors and administrators waive and release any and all claims for personal damage I may have against the city of Somerville where the event is being held in, organizers, B.A. Event Promotions, Somerville Striders Athletic Club, Paul Collyer, all sponsors of the race and I attest and verify that I am physically fit and sufficiently trained for this event on 3/18.12. I also understand that there are no refunds regardless of the circumstances. I also understand that I must be present to receive any merchandise I have ordered - WE WILL NOT MAIL OUT |
Please address all
checks and money orders to B.A. Event Promotions
and mail to
B.A. Event Promotions 224 1/2 Chandler Street #1
Worcester, Massachusetts 01609
(617) 625-2140