South Salem Presbyterian Church

2008 Adult Race registration Form

32nd Annual Memorial Day Celebration

For More Information, Call 914-763-9282

5K
(Starts at 9:00 AM)
10K
(Starts at 9:30 AM)
4.3 K Health Walk
(Starts at 9:45 AM)

Save $5 by Pre-Registering (Must be received by May 15)

Race Day Information

Race Center: South Salem Library, Main Street, South Salem, NY

Events: 5K & 10K Races and Health Walk

Results: Posted at Noon at the Church and mid-afternoon on www.southsalempc.org/races

Awards: Ceremony, Noon — Church Entrance

Registration

  • Pre-Registrants pick up numbers, timer chip and, if among first 300 registrants, pick up t-shirt. (Pre-Registration is highly recommended as lines can be long on RACE DAY!)
  • Race Day-Registrants provide completed form and check, receive number and timer chip. (If registering on RACE DAY please complete form and check in advance.)

Please arrive at Library 45 minutes to an hour prior to race time !!

Course maps are available at www.southsalempc.org

Race Sponsors

    Aquafina — Pure Water - Perfect Taste
  • MC Energy, Inc.914-767-3100
  • State Farm Insurance914-232-7444
  • Cross River Wine Merchant914-763-WINE
  • Houlihan/Lawrence, Inc.914-764-1223
  • Marshall Oil Co., Inc.914-764-5766
  • CAPtech Inc.914-633-0570
  • Design House Advertising203-438-7204
  • Dr. Stuart Weitzman914-242-8810
  • Minuteman Press® of Danbury203-743-6755
  • Race Bibs supplied by Lewisboro Physical Therapy914-763-5941

Directions:

In New York: From Rt. 684 (Exit 6) or Saw Mill: East on Rt. 35 about 8 miles. Pass Yellow Monkey Village on left, straight thru traffic light. Pass Mobil and after Fire House on left, take first left onto Spring Street. Left onto Main Street at 1st intersection. Library tenth of mile on right.

In Connecticut: Rts. 7, 33 or 123. Drive West on Rt. 35. About 1 mile past South Salem Animal Hospital, turn right onto Spring Street and proceed as above.

Registration Form

Registration Instructions

  1. Fill out form below, completing every portion to avoid registration delay.
  2. Make sure you sign form for yourself and/or for your child(ren) if under 18.
  3. Clip completed form and send with tax-deductible check (see fees below)
  4. Make checks payable to South Salem Presbyterian Church.
  5. Mail to Memorial Day Races, c/o South Salem Presbyterian Church, P.O. Box 399, South Salem, NY, 10590, for receipt by May 15, 2008
Registration Fees
EventPre-Registration
(Per Person)
Race Day
(Per Person)
5K/10K$20$25
Group Discount*$18No discount on race day
Health Walk$10$15
T-shirtsTo first 300 registrants
* Minimum of 4 runners — All registrations must be in same envelope

BE SURE TO SIGN THIS WAIVER: You cannot race if you haven't signed.

In consideration of your accepting this entry, I, the undersigned, intending to be legally bound, hereby for myself, heirs, executors and administrators, waive and release any and all rights and claims for damages I may accrue against the directors and operators of the South Salem Presbyterian Church, their successors and assigns for any and all injuries suffered by me in said event. I attest and verify that I will participate in the event as a footrace or health walk entrant, that I am physically fit and have sufficiently trained for the completion of this event and my physical condition has been verified by a licensed medical doctor. Further, I hereby grant full permission to any and all of the foregoing to use photographs, videotapes, motion pictures, recordings or any other record of this event for any legitimate purpose.

Adult (18 & Over)__________________________________________________ Date ______ 2008

Parent Signature (for entrant under 18) __________________________________ Date ______ 2008

PRINT Last Name _________________________________________ Age on May 26, 2008 _______

PRINT First Name _________________________________________

Gender (Circle) Male Female

Event (Circle One) 10K    5K    4.3 K Health Walk

First 300 Pre-Registrants Receive T-shirts (Circle One) S     M     L     XL

Street Address _________________________________

City ______________________________ State _________ Zip ________

Include tax-deductible entry fee, payable to South Salem Presbyterian Church
Mail to: Memorial Day Races c/o South Salem Presbyterian Church, P.O. Box 399, South Salem, NY 10590.