Mail-in Registration Form
The Contoocook Carry –September 27, 2009
Name: 
City:
State:  Zip: 
Daytime Phone: Date of Birth:  Age on race date:
Pre-register by September 18th
Free t-shirts to first 100 paying participants.
Pre-register by September 17th for two free raffle tickets.
Free raffle ticket to every participant/Free hardwood seedling to 60 racers
Team Name: ______________________________ Using Racing Tandem Bike?
Team Member Names/Ages/Shirt Size (Small/Medium/Large/Extra Large & Youth Large)
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Adults: $25/person ($75 Max per Team) ___x$25= ________
14-18 Years: $15 per person/$60 Max per Team ___x$15= ________
10-13 Years: $10 per person/$40 Max per Team ___x$10= ________
Differently Abled:$10 per person/$40 Max ___x$10= ________
9 & Under: Free
Additional Donations: Tax-deductible matching funds from employers, sponsor gifts and pledges gratefully accepted.
Additional For Fuel Assistance ________
Checks made out to Town of Hopkinton Total enclosed: $________
Mail Entry to: Mary Congoran, 362 Old Holmes Road, Hopkinton, NH 03229
Waiver Must Be Read and Signed Before Mailing: I know that running, paddling, and biking are potentially hazardous activities. I should not enter 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 triathlon. I assume all risks associated with running, paddling or biking in this triathlon 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, the Contoocook River, 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 acceptance of my application, I, for myself and anyone entitled to act on my behalf, waive and release The
Contoocook Carry, The Town of Hopkinton/race sponsor, their representatives and successors, The Norma Herrick Estate and its heirs, and The Thomas Kerins Estate and family, as well as claim of loss or damage of personal property from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. All fees are nonrefundable.
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Signature Date Parent’s Signature if under 18 years of age
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