Mail-in Registration Form
The Contoocook Carry – September 21, 2008
Make Checks Payable To: |
Town of Hopkinton |
Mail Entry To: |
Mary Congoran 362 Old Holmes Road Hopkinton, NH 03229 |
Name: 
Address:
City:
State:  Zip: 
Daytime Phone: Date of Birth:  Age on race date:
Gender:  M F
Shirt Size XL L M S
Free t-shirts to first 150 paying participants.
Pre-register by September 17th for two free raffle tickets.
Limited canoe/kayak connection available – call Mary 529-2692 or e-mail at tcongoran@hotmail.com to get help.
Team Name: ______________________________
Runners: List all by name, age, gender, and shirt size (if paying)
Paddlers: List all by name, age, gender, and shirt size (if paying)
Bikers: List all by name, age, gender, and shirt size (if paying)
Using Racing Tandem Bike? ?
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: Matching funds from employers, sponsor gifts and pledges gratefully accepted and are tax-deductible.
Additional For Fuel Assistance ________
Checks made out to Town of Hopkinton Total enclosed: $________
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 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.
_____________________________________ __________ _______________________________________________
Signature Date Parent’s Signature if under 18 years of age
| 
