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Click here to sign up for 5K on line
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Click Here for Facebook 5K Run/Walk Page
Click Here for 5K Run/Walk Route
Dracut Old Home Day Road Race 5K Run/Walk Dracut High School Complex, 1580 Lakeview Avenue, Dracut Ma 01826 Saturday, September 7, 2013, 10:00 A.M. To register by mail, fill out this application or register online
at www.active.com Make
checks payable to Dracut Old Home Day Road Race Mail to : Dracut Old Home Day Race Committee, PO BOX 217, Dracut, Ma 01826 Entry Fee is $20 if postmarked no later than September 1,
2013. Day of Race $25.
First Name________________________________________________________________________________________________________________________ Last Name ________________________________________________________________________________________________________________________ Male______________________Female_____________Date of Birth (MM/DD/YY)________________Age Day of Race__________________________ Street Address or P.O. Box ____________________________________________________________________________________________________________ City/Town__________________________________________________________________________________________________________________________ State_____________________________Zip
Code______________________________T-Shirt Size (M-L-XL-XXL)______________________________________ E-Mail Address (please print neatly)____________________________________________________________________________________________________
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Waiver Must be Read & Signed Before Mailing I know that running is a potentially hazardous activity. I should not enter
or run in this event unless I am medically able and properly trained. I agree to abide by any decision of a race official
relative to my ability to safely complete the run. I assume all risks associated with running in this race including, but
not limited to, falls, contact with other participants, the effects of weather, including high heat and/or humidity, the conditions
of the road and traffic on the course, all such risks being known and appreciated by me. Having read this waiver and knowing
these facts, and in consideration of your acceptane of my application, I, for myself and anyone entitled to act on my behalf,
waive and release Dracut Old Home Day and the Town of Dracut, Ma, State of Mass. and all sponsors, their representatives,
and successors from all claims or liabilities of any kind arising out of my participation in this event even though the liability
may arise out of negligence or carelessness on the part of the person named in this waiver. I also allow my name to be posted
in various medias. All fees are nonrefundable. ___________________________________________________________
_______________________________________________________________________ Signature (parent or guardian must sign if under 18 years old)
Date WHEN PRINTING
APPLICATION, PRINT IN LANDSCAPE MODE
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Logistics for
Dracut Old Home Day Road Race 5K Run/Walk Saturday September 7, 2013, 8:00 AM Dracut High School Complex, 1580 Lakeview Avenue, Dracut Ma 01826 - Cash Awards Overall (Male & Female)
- 1st Place $100, 2nd Place $50, 3rd Place $25
- Medal Finishers (Top 3 Each Age Group) - 19 &
under, 20-29, 30-39, 40-49, 50-59, 60-69, 70+
- Designated Participant Parking - Dracut High School
Monument Lot (corner of Lakeview Ave and Fredrick St), behind High School (some road closed so arrive early)
- Additional
Information & Contacts - www.dracutoldhomeday.com, www.active.com, www.facebook.com/dracutoldhomedayroadrace,
or e-mail: cattaylor@cocoearly.com.
- Road Race Fee - Preregistration $20, Day of Race $25
- Mail-In
Registration Deadline - Postmarked no later than Saturday, September 1st
- Race Number Pickup &
Walk In Registration - Thurs, Sep 5 and Fri, Sep 6, 1:00 PM to 7:30 PM at Coco, Early and Associates, 1168 Lakeview
Avenue, Dracut Ma
- Race Day Registration - 8:00 AM to 9:30 AM at Dracut Car Wash, 20 Turgeon Ave,
Dracut, Ma (Across Lakeview Ave from Old Home Day Site)
- Race Timing - Professional Bib Chip Timing
by Yankee Timing
Followed by Dracut Old Home Festivities!
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Road LLOGISTICSDRACUT OLD HOME DAY
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A Dracut Community Event Since 2001
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