|
Race Application
Please Print, Complete, Sign, Make Payment & Mail to our offices at:
OCEAN DRIVE RUN CLUB, INC.
5712 Pacific Avenue
First Floor Front Office
Wildwood Crest, NJ 08260
| Name |
: ______________________________USATF-NJ Member #_____________ |
| Street Address / PO Box |
: __________________________________________________________ |
| City |
: __________________________________________________________ |
| State / Province |
: ___________ Zip/Postal Code: _______________ |
| Country |
:_______________________________ |
| Home Phone |
: _______________________________________ |
| Work Phone |
: _______________________________________ |
| E-mail Address |
: _________________________________________________________ |
| Age on Race Day |
: ______ Date of Birth: ___________________ |
| Circle Gender |
: Male Female |
| Circle T-Shirt Size |
: Small Medium LargeX-Large |
| Circle Event |
: Marathon10 M 5K1.5 Mile Fun Run |
| PR for race entered |
: ______________ |
| ENTRY FEE |
Marathon |
10-Miler |
5k |
1.5 Mile |
| By 12/31/08 |
TBD |
TBD
|
TBD |
TBD
|
| By 02/28/09 |
TBD |
TBD |
TBD |
TBD |
| Before 03/27/09 |
TBD |
TBD |
TBD |
TBD |
| At EXPO |
TBD |
TBD |
TBD |
TBD |
|
Add $6 to have Race Number Mailed
Deduct $2 for USATF-NJ Discount
|
Entry Fee Enclosed
US Dollars only, no refunds granted |
________ |
|
| WAIVER: Read and sign. In submitting my entry, I, for myself, my heirs, executors and administrators, do hereby waive and release any and all claims for damages I may have now or here after arising against the Ocean Drive Run Club, Inc., the Ocean Drive Marathon, Ocean Drive 10-Miler, Ocean Drive 5K and 1.5-Mile Promenade, the County of Cape May, any agency thereof, the Cape May County Bridge Commission, the municipalities of Cape May, Lower Township, Wildwood Crest, Wildwood, North Wildwood, Middle Township, Stone Harbor, Avalon and Sea Isle City, the USATF, all sponsors and their employees, officers, directors, principals, agents, representatives, successors and assigns, including, but not limited to, any and all claims of damages, injuries, demands, actions, whatsoever however they may occur, arising as a result of my participation in said events. I acknowledge that I am aware of the inherent risks associated with participation in events of this type. I attest and verify that I am physically fit and have properly trained for the completion of these events and my physical condition has been verified by a licensed medical doctor. Furthermore, I hereby grant full permission to any / all of the foregoing to use my name, voice, and/or picture in any broadcast, telecast, advertising promotion or other account of these events for any purposes whatsoever. I understand that entry fee is nonrefundable and race numbers non transferable. |
| Signature |
: _________________________ |
Date |
: _______________ |
Signature of Parent
for entrant under 18 |
: _________________________ |
Date |
: _______________ |
|
609-523-0880 
