Registration Form for Mail-In Registration

Time:
8:00 Registration
9:15 Youth Races
10:00 5K Road Race & 3K Run/Walk

Place:
Exeter-West Greenwich Jr./Sr. High School
930 Nooseneck Hill Rd.(Route 3)
West Greenwich, RI 02817

Distance:
Ages 6 & Under, 7-8: 200 Meters
Ages 9-12: 400 Meters
Run/Walk: 3K (1.8 miles)
Road Race: 5K (3.1 miles)

Entry Fee:
$15.00 per adult (prior to Oct. 22nd)
$20.00 on race day
$10.00 for students
$5.00 for youth races (T-shirts available to purchase)

Checks can be made payable to: EWG Kids, Inc.
Registration fee is non-refundable.
Additional donations welcomed.
Please Print and Mail to: EWG Sports4Kids, Road Race, P.O. Box 1081, Coventry, RI 02816


Last Name: _____________________________ First Name: ____________________________

Street Address: ______________________________ Town: __________________ State:_____ Zip: _______

Age (race day): _____ Date of Birth: _________ Sex: ___M ___F

Phone: ___________________ ___5K ___3K ___Youth Race

Corporate Team Name: __________________________________________

Please Print E-mail (for use by EWG Sports4Kids only): ______________________________

Shirt Size (1st 200 5K or 3K Registrants receive shirts):

___SM ___MD ___LG ___XL

Waiver:

(Must be signed by all participants, including corporate team entries)
In consideration of the acceptance of this entry, I hereby for myself, heirs, executors, and administrators, waive and release any and all rights and claims for damages I may have against Exeter-West Greenwich Regional School District and organizations affiliated with the district, the EWG Sports 4 Kids group, the towns of Exeter and West Greenwich, sponsors, race officials, organizers and volunteers associated with this event for any injury that may occur as a result of my participation in this event.

Sign Here (Parent must sign if entrant is under 18 years of age)

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