Lowells 1st Run 5k and 10k
Mon Jan 1, 2018
5k Entry:11:00 am$30.00
10k Entry:11:00 am$35.00
BIB #

PAPER APPLICATION

Note: Lines 1-4 are mandatory. You cannot be entered into the race if they are not complete and legible.
1First Name 
2Last Name 
3Gender   MALE      FEMALE      (please circle one)
4Age(your age on race day)

5Birthday 
6Address 
7  
8City 
9State 
10Zipcode 
11Phone 
12Email 

Signature: __________________________________________________________ Date ____________________

Parent Signature (if under 18) ______________________________________ Date ____________________

My signature is in agreement to the following Waiver:

I know that running is a potentially hazardous activity. I should not enter or run this event unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risks associated with running in this race including, but not limited to, falls, contact with other participants, the effects of weather, including high heat and/or humidity and cold/freezing temperatures,  the conditions of the road and traffic on the course, all such risks being known and appreciated by me. Having read this waiver and knowing these facts, and in consideration of your acceptance of my application, I, for myself and anyone entitled to act on my behalf, waive and release Hustle Up Racing, Yankee Timing, The Lowell Elks and the city of Lowell, MA, and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the individuals named in this waiver.  I agree to allow my name and likeness to be published in social media, and  I further understand that fees are non-refundable, and non-transferable.  I further understand that this is a wintertime race, and cancellations and postpoinements are a possibility in New England. I will not ask for any special consideration for myself or my registration under any circumstances.