Relay Entry Form

Fire Fighters 10 Mile Road Race Race Sponsored by Half-Way Motors/Nissan You can contact us for more information on relays: relays@10mileroadrace.org
*School Relay Challenge* ~ Monday, May 23^rd, 2011
	Entry Fee	$25.00/team	by Thursday, May 12^th
	Late Entry	$40.00/team	Friday, May 13^th to Wednesday, May 18^th
	(make cheque payable to: 10 Mile Road Race) (make cheque payable to: 10 Mile Road Race) (make cheque payable to: 10 Mile Road Race) (make cheque payable to: 10 Mile Road Race)

¡ Divisions:

¡ Elementary School teams - three categories (male, female, mixed-minimum 2 females)

¡ High School teams –Open Category

¡ Open Category - Under 14, 14-17 or non school related (i.e. hockey teams, friends etc.) – Open Category

¡ Five members per team

¡ Each team member must run 2 miles

¡ Team co-ordinator responsible for delivery and pickup of team member from each handoff point

¡ Kit pick-up (including baton) at HALFWAY MOTORS/NISSAN

Thursday

May 19^th

5-7 p.m.

Friday

May 20^th

5-7 p.m.

Saturday

May 21^st

2-4 p.m.

Knights of Columbus Centre

Sunday

May 22^nd

4-7 p.m.

Option to purchase race tee shirt ($15.00) or attend Spaghetti Dinner ($10.00).Dinner Sunday, May 22^nd from 5 to 7 p.m.

Complete and return to:

Fresh Air Experience

Elementary School

High School Open

Team Name

School Name

Division: Elementary

Male

Female

Mixed

High School Open

Under 14 Open

14-17 Open

Team Name:

Team

Members

Team Contact

Name

Address

Phone

Fees

Entry

___________

T-shirt(s)

($15.00 x ___)

___________

Size

Spaghetti Dinner ($10.00 x ___)

___________

Total

___________

WAIVER

By accepting this entry I hereby waive and release the Thunder Bay Professional Firefighters Association, the City of Thunder Bay, all sponsors, and members of the organizing committee and all other volunteers of all claims and all responsibility of damages, injuries, and loss of articles which team members may sustain as participants in the Ten Mile Road Race. I acknowledge and understand all risks associated with this event and attest that team members are sufficiently trained to participate. I have read and fully understand this waiver/release.

Team Representative

(must be 19 years or older)

10 Mile Road Race