Jimmy Williams Memorial 5K Run Registration Form. Saturday, May 3, 2014 at 10am at Willow Metropark 22900 Huron River Drive, New Boston, MI 48164. Event Cost: Early Registration $25 – by April 5, 2014 Late Registration $30 – between April 6 and April 30, 2014 Day of Race $35.
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Saturday, May 3, 2014 at 10am
at Willow Metropark
22900 Huron River Drive, New Boston, MI 48164
Mail Entries to: Jimmy Williams Memorial Run
26070 Whispering Willows Drive
New Boston, MI 48164
City: _____________ State: _____ Zip Code: _________
Telephone: ______________ E-mail: ________________
Gender (M/F): ______ Age (on 5/3/14): ________
Select T-Shirt Size: Youth S M L XL
Adult S M L XL
In consideration of acceptance of my race entry, I, for myself, my executors, administrators, and assignees, do hereby release and discharge the Jimmy Williams Memorial Run/Scholarship, the City of New Boston, all sponsors, supporters, participants, and spectators for all claims of damages, demands, actions whatsoever in any manner arising from my participation in said event. I attest and verify that I have full knowledge of the risks involved in this athletic event, am physically fit to participate in this event, and have my physicians approval. Further, I hereby grant full permission to any of the aforementioned to use my photograph, videotape, film, motion picture, or record of my participation in this event.
Parent Signature (if participant is under 18) _____________________________________