Text Box: Click on the form below to fill-out and print an entry form

Text Box:   Sunday, July 14				
  Start Time 6:30 PM
  Clinton Community Center
  67 Halstead St, Clinton, NJ  08809

 •  5K Entry Fees:
     Pre- Entry  $25*
     Post-Entry $30
Pre Entry Deadline: 7/4/13

  • 1 Mile Fun Run & 
     Fitness Walk:
     Pre Entry $12
     Post Entry $15



(One entry form per person)               OFFICIAL ENTRY FORM             (One entry form per person)

CHECKS PAYABLE TO: Sprintin’ Clinton, PO Box 5435, Clinton, NJ  08809    bfischer1960@comcast.net
Name  		___________________________________		Sex:  ____Male  ____Female
Address 		___________________________________		Age ______(on race day)
City 		___________________________________		Date of Birth ______________(mo/day/yr)
State 		_____________  Zip  _________________		T-Shirt:   S        M       L     XL (circle one)
Phone		(_____)_____________________________		2013 USATF-NJ #_____________(if member)
E-mail		___________________________________	
EVENT:      ____5 K (6:45PM)       _____1 Mile Fun Run/Walk (6:30PM)

*USATF-NJ members are eligible for a $3 pre-entry discount

WAIVER/RELEASE: In consideration of being accepted in the athletic event described in this application; I, for myself, my heirs, my executors, administrators and assigns, do hereby expressly release and discharge the town of Clinton, the township of Clinton, the state of New Jersey, The New Jersey Water Supply Authority, USATF, USATF-NJ, Clinton Sunrise Rotary, sponsors and volunteers of this event, it’s officers, agents, servants and employees, and its successors and assigns (hereinafter “Release”) from any and all claims, demands, liability actions or judgments of any kind whether caused by the negligence of said Release or any of them otherwise which I now have or in the future have against said Releases or any of them arising out of participation in the athletic competition which is the subject of this application.   


____________________________________________					______________________
Signature of Participant (Parent/Guardian if Under 18)					               Date

Awards to the Top 3 Male and Female Overall and Top 3 in 19 & under; 10 year age groups 20-29 thru 70-79; 80+.

 

Questions:  (908) 279-0112       www.sprintinclinton.org