Summer Fun/Rascals Registration Form 2008
Paxton Summer Solstice 5K Race 2018
Registration Form
5K fun run/walk - 6pm Saturday, June 9th $15 per participant
$10 if received in advance
12 years old and under $5 (Checks make payable to: Town of Paxton)
Shirts to the first 20/30 runners. Medals/Trophies to the top runners.
Also this is a family fun race: 1st family (one parent and one child 12 and under) to have the best time will be acknowledged
Registration starts at 5:30 in the Church Parking Lot Across from Richards Memorial Library – Richards Ave, Paxton
Mail to: Paxton Recreation, 697 Pleasant Street, Paxton MA 01612
Name: ____________________________________________Age_________Gender___________
Parent’s Name (if under 18) ________________________________________________________
Address: ________________________________ Town/Zip Code: __________________________
E-Mail:____________________________ Shirt size YS YM YL AS AM AL AXL AXXL
I agree not to hold responsible the Paxton Recreation Commission; the Town of Paxton; or any of the parties connected with this program for any accident or injury that may occur during the program. I understand that if my child becomes a discipline problem, he/she will be dismissed from the program without a refund. I also grant permission for the Recreation Staff to seek medical care for me/my child in the event that I cannot be reached.
Signature (Parent/Guardian if under 18): ___________________________________Date:____________
I give permission for any pictures taken of me or my child in this program to be displayed: __________ (initial)
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