attn: Shawn Sirios
Dracut, MA 01826
City: State: Zip:
Daytime Phone: Date of Birth: Age on race date:
Gender: M F T-shirt Size: S M LG XL
Are you a Firefighter? Yes Where?
Must Be Read and Signed Before Mailing:
In consideration of this entry being accepted, I for my heirs, executors
& administrators waive and release any and all claims for personal
damages I may have against the organizers, City of Lowell,, sponsors
of this race and volunteers. I attest and verify that I am physically
fit and have sufficiently trained for this event. Entry is non-refundable.
Date Parent's Signature if under 18