Strides Road RaceRegistration FormPlease fill in the information below to register.Sunday October 12, 2008
At Camp Harkness
301 Great Neck Rd
Waterford, CT 06385

Starting Gun Times
10K	10:00 AM
5K	11:30 AM
1 Mile Family Run/Walk	1:00 PM
All races start and finish at Camp Harkness

First Name Last Name Sex Age T Size Race 10K 5K 1 Mile Family Fun Run/Walk Wheelchair Division No Entry - Ad or Contribution only $15 per runner $30 per family (max 4) Family Member (already paid) $5 Children under 12 Ad or Contribution only Fee

	Yes - I will sponsor an ad
	No

Patron Ad ($50) Contribution NonPaying Family Runner, enter Family Member Paying Street City State Phone Waiver: (Must be signed by each runner in order to participate - Under 18 be signed by parent/gaurdian). In consideration of my accepting this entry, I do hereby for myself, my heirs, executors, waive, and release forever and discharge any and all claims for damages which I may have or which hereafter may occur to me against The Arc of New London County, The Cactus Jack Foundation, The Department of Mental Retardation, Camp Harkness, Outback Steakhouse, The Town of Waterford, and any other sponsors of all claims arising out of my participation in said athletic event. Accept Waiver (see Waiver below)

	Yes
	No

Please fill in your address below in case of emergency:You must accept waiver by selecting  Yes. Zip

	Male
	Female

Please enter the family member making payment.Version 1.0b 020508