Online Registration

MMBA Presents 7th Annual
Firefighters' Frozen 5K & 1 Mile Fun Run

 

     

WWW.MMBA40.COM
Saturday, December 12, 2009
Hosted by the
McKinley Heights Mutual Benefit Association

  

1 mile fun run starts at 9:00 AM
5K run starts at 9:30 AM
Registration begins at 7:30 AM

Pre-registration is $14.00 (if received by November 30th)
Runners can register on race day beginning at 7:30 AM for a $16.00 fee.
The first 100 registrants receive a long t-shirt.

Additional Information And Mail In Application www.mmba40.com

Online Registration Will Close On 12/1/09
 
  
               
Please notify garydsmith@runwalkjog.com if you experience problems with online registration.  For online registration a processing fee of $1.50 will be added to the registration fee for each participant.
                         
Firefighters Frozen 5K
  
                    Last Name:


                    First Name:


                                Age:


                                  Sex:


                         Address:


                                City:


                              State:


                                  Zip:


                             Phone:


               Adult Shirt Size:


                               Event:

Waiver:  In consideration of the acceptance of this entry, I waver and release, for myself, my heirs, and my assigns, any and all rights and claims for injury and damage which I might have against the Township of Weathersfield, MMBA, and all sponsors as the result of any and all injuries which I might be received during this contest. I hereby attest and certify that I am physically fit and have sufficiently trained for this run.


        Agree With Waiver:


                        Signature: (parents’ signature if under 18)


  Firefighter Department:



 
   
Online Payments
   
          
   

Acceptance Mark
  

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