10th Annual Ray Crothers Memorial 5K X-C Race and Kids Mile Fun
Saturday, September 22, 2018
10th Annual Ray Crothers Memorial 5K X-C Race + Kids’ Mile Fun Run
Ray was a legendary runner at CCSU, finished 1st in 3 divisions (HS, Open, Masters) at the Manchester RR
New for 2018-Alumni or Club Team Challenge
Combined 3 Men+3 Women Team (any age)
$250 in Prize $$$
USATF/CT 2018 Cross-Country Grand Prix Sanctioned Event & MRR Qualifier
Sponsored by: CCSU Athletic Department and CCSU Alumni X-C, Track and Field Club
A 5K Cross Country race honoring Ray Crothers for his Cross-Country accomplishments (hereinafter, the “Activity”)
All fees & donations are appreciated and will benefit the CCSU Men’s/Women’s X-C & Track and Field Intercollegiate Program
Location: Stanley Quarter Park, 115 Eddy Glover Blvd. New Britain, CT (adjacent to Central Connecticut State University)
Date: Saturday, September 22, 2018
Time and Distance: 8:30 a.m., Kids’ 1 Mile Fun Run (No entry fee)
9:00 a.m., Ray Crothers 5K X-C Race
11:00 a.m., Women’s 5K X-C Collegiate Race (Ted Owen Invitational)
11:45 a.m., Men’s 8K X-C Collegiate Race (Ted Owen Invitational)
Entry Fee: 5K Race fee is $20--On-line registration: www.fasttracktiming.com
Please pay on race day: Make checks payable to CCSU
Race Day Registration opens @ 7:30 a.m. CCSU Student Fee w/ID is $5
Awards: Prizes will be awarded to the top 3 in each age group category. A hospitality tent will be available.
T-shirts to first 100 on-line entries. Alumni or Club Team, 1st place $125, 2nd place $75, 3rd place $50
Timing by: Fasttracktiming.com
Co-Race Directors: CCSU Coach Eric Blake, 860 832-3054 firstname.lastname@example.org
Larry Chaves, 860 521-4097 LandLtaxes@aol.com; Walter Fitzpatrick, 860 666-4112 email@example.com
Alumni/Club Team Challenge- Mike Bendzinski 860 335-3545 firstname.lastname@example.org
First Name: __________________________ USATF/ Alumni/Club Team Name:_________________________
Last Name: ______________________________________________________________
Age on 9/22/2018: _______________ Male/Female: (M/F) ___________
Age Group: (Circle or highlight below)
· Kids’ Fun Run for age 12 and under
· 5K X-C Race=> 0-18 19-29 30-39 40-49 50-59 60-69 70 and older
City: ________________________________________ State: _______________ Zip: ________________
I recognize that there are risks and hazards directly or inherently involved in the Activity and that I may become injured during my participation. With full knowledge of the facts and circumstances surrounding this Activity, I voluntarily undertake this Activity and assume all responsibility and risk from my participation in this Activity, including all risk of loss of limb or life, property damage, injury to others, and other hazards to me.
I assure officials of CCSU that I have adequate health insurance necessary to provide for and pay any medical costs that may directly or indirectly result from my participation in this Activity and that I will indemnify and hold CCSU and its employees and agents harmless.
I assure CCSU that there are no health-related reasons or problems that preclude or restrict my participation in this Activity.
I, for myself, my heirs, executors and assigns, hereby release CCSU and its employees and agents, from any liability whatsoever arising out of my participation in this Activity, including but not limited to, any damage to my property or the property of others and injury to me or to others, including loss of limb or life, resulting from my negligence or the negligence of others, or to others through my participation in this Activity.
The foregoing is submitted in consideration of CCSU allowing my participation in this Activity. I execute this document with full knowledge of the contents and consequences stated in this Entry Form & Release.
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