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)

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download