Mail-in Registration Form
Lowell Firefighters Road Race - June 4, 2017
Make Checks Payable To: Lowell Firefighters Road Race
Mail Entry To:

LFF Road Race
attn: Shawn Sirios

15 Robert Street
Dracut, MA 01826

Name: Address: 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? Email address:
FEES: $25

Waiver 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.

_______________________________ _____________ _____________________________________

Signature Date Parent's Signature if under 18

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