First Name*

    Last Name*

    Address*

    City*

    State*

    Zip Code*

    Your Email (required)

    Gender

    Birthdate

    Phone Number*

    T-shirt Size (for first 100 applicants)

    Emergency Contact Name

    Emergency Contact Number

    Running or Walking?
    RunningWalking

     

    Review and Sign Waiver: In consideration of the acceptance of this entry: myself, heirs, executors and administrator, waive and release any and all rights and claims for damages I may incur against The City of North Adams and the North Adams Police Department, all race sponsors and organizers, volunteers and officials for any injuries suffered by me while competing in and or traveling to and from this event. I also willingly release my image to photography, video and film cameras which may be involved with this event.

    Signature Initials*