JIM FERRIS MEMORIAL 5K RACE APPLICATION
Name:________________________________ Sex: M F Age:_____
Address:_________________________________________________
street city zip
T-shirt Size (adult male sizes): S M L XL XXL
In consideration of your accepting this entry, I, for myself, and anyone acting on my behalf, waive and release the Village of Holley, the Town of Murray, the Murray-Holley June Fest, the Holley School District, all the sponsors, their relatives and successors, from all claims of liabilities of any kind arising out of my and/or my child's participation in this event even though the liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I and/or my child agree to abide by all traffic rules and regulations set by the Village of Holley, Town of Murray, and/or the State of New York.
Signature of entrant________________________________________
If entrant is under 18, parent's signature also required:
Date:_________________ 2012
