Kennebunk Beach Classic 5K
Sun Jun 3, 2018
5K Run and Walk - Juniors (under 13):9:30 am$25.00
5K Run and Walk - Seniors (65+):9:30 am$25.00
5K Run and Walk - adults 19 to 64:9:30 am$25.00
RSU21 Students (up to age 18):5:00 pm$10.00
BIB #

 Please note start time for all is 9:30 am on Sunday, June 3, 2018.  

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 
13Are you a student in RSU21? RSU21 student runners up to age 18 get $10 rate. 
14How did you hear of this race? 
15Are you on a team? 

Signature: __________________________________________________________ Date ____________________

Parent Signature (if under 18) ______________________________________ Date ____________________

My signature is in agreement to the following Waiver:

I know that running a road race is a potentially hazardous activity.  I should not enter and run unless I am medically able and properly trained.  I agree to abide by any decision of race officials regarding my ability to safely complete the run.  I assume all risks associated with running this event including, but not limited to, falls, contact with other participants, the effects of the weather, including high heat and/or humidity, traffic and the conditions of the road; all such risks being known and appreciated by me.  Having read this waiver and knowing these facts, and consideration of your accepting my entry, I for myself and anyone entitled to act on my behalf, waive and release the Center, Race Officials, all sponsors and their representative, and the Town of Kennebunk and its employees from all claims or liabilities of any kind arising out of my participation in this event.