Mail in Entry Form - Kennebunk Beach Classic

PLATINUM SPONSOR:
8th Annual KENNEBUNK BEACH CLASSIC 5K Run & Walk
24th Anniversary Road Race to Benefit the Senior Center at Lower
Village
Honoring the Memory of Hank Spaulding
Sunday, June 7, 2015
♦Scenic, blazing fast, certified 5K (ME08004RF)
♦Free t-shirts to first 200 pre-registered BY MAY 1.
♦Timing by Granite State Race Services using ChronoTrack disposable tag system
♦Cash awards top 3 overall, male/female
♦Age-graded top 15 overall
♦Fresh baked goods and refreshments
Start time:
9:30 a.m. RAIN OR SHINE
Start and finish at Lower Village
Entry fee:
Pre-registration: Juniors (Age 12 and under) $15; Seniors (Age 65+) $15; ALL OTHERS $20
Race day registration is $25 for all, from 8:00am – 9:15am
Late registration/race packet pick up at Senior Center at Lower Village, 175 Port Road, Kennebunk
Pre-registered (by mail 6/2/15; in person 6/5) Race packet pick up Saturday, June 6 from 9:00-3:00; race morning until 9:15
Race Info:
Senior Center at Lower Village
175 Port Road
Kennebunk, ME 04043
Telephone: 207-967-8514
Email: [email protected] Web: www.kennebunkbeachclassic.com
Proceeds of race to benefit the Senior Center at Lower Village, a 501(c) non-profit charitable organization
Register on-line at www.runreg.com or complete the form below
____________________________________________________________________________________________________________
PLEASE PRINT CLEARLY TO AVOID MISTAKES
Name ________________________________________________Sex (
) F ( ) M
Shirt Size: YOUTH : ( ) S ( )M ( )L
Address______________________________________________________ Age _____on 06/01/2014 ADULT: ( )S ( )M ( )L ( )XL ( ) 2XL
City__________________________________ State______________ Zip _____________Phone #_______________
Email address:_______________________________
Are you a member of the Senior Center?
( )Yes
( )No
Signature___________________________________________ Date __________________
Entry must be signed. I know that running a road race is a potentially hazardous activity. I should not enter and run unless
I am medically able and properly trained. I agree to abide by any decision of race official regarding my ability to safely
complete the run. I assume all risks associated with running this event including, but not limited to, falls, contact with other
participants, the effects of the weather, including high heat and/or humidity, traffic and the conditions of the road; all such
Mail Entry Forms
risks being known and appreciated by me. Having read this waiver and knowing these facts, and consideration of your
with Check Payable to:
accepting my entry, I for myself and anyone entitled to act on my behalf, waive and release the Senior Center at Lower
Sr Center at Lower Village
Village, Race Officials, all sponsors and their representative, and the Town of Kennebunk and its employees from all
175 Port Road
claims or liabilities of any kind arising out of my participation in this event.
Kennebunk, ME 04043
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Sorry, I cannot participate in the Kennebunk Beach Classic, but my gift of $_____ in support of the Senior Center is enclosed