Jeff Perryman - Race Director Email manomartian5K@lycos.com
Register online at www.active.com
Please fill out form completely and clearly to ensure accurate registration
Name_______________________________________________Age________Male_____Female_____ (Check One)
Address___________________________________________________
City, State, Zip ______________________________________________
Phone__________________ Email______________________________
Circle One - Shirt Size: S M L XL
Circle One - Race Walk
Make check payable and mail to:
Manomartian Racing Services
21 Fremont St.
#2 Plymouth, Ma
02360
Waiver: In consideration of my entry and acceptance in the Plymouth Manomartian 5K Race/Walk I, on behalf of myself, my heirs and assigns, waive any and all right and claims for personal injuries, damages, expenses, and any loss whatsoever, that may arise as a result in my participation in the Plymouth Manomartian 5K Race/Walk and release and hold harmless any and all race officials and sponsors.
Signature_____________________________________ (Parent if runner is under 18 years old)
Pre
Registration
$20.00
Web Registration
or
Postmark May 9th
or
before
$15.00 Ages
17 and
Under
$15.00
Colonial
Road Runners/Marshfield Road Runners
- Members
Post
Registration
$20.00 May 10th through May 15th
Day of
Race
$25.00 May
16th