Saturday, November 26, 2011
9:00 am
Rain or Shine!
Westmont Fire House
120 Haddon Ave. Westmont NJ
This Year's Race Benefits:
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Contact Commissioner Foley at 856-854-1176 ext 4156
jfoley@haddontwp.com
Flat and Fast on Streets of Haddonfield and Haddon Township
The Pour House
The Starting Point Inc.
Cork
PBA LOCAL #257
Westmont Fire Co. #1
Haddon Tree Company
Diener Brick Company
Brown and Connery
1st Colonial Bank
Haddon Township Police Dept.
Haddonfield Running Company
Westmont Ace Hardware
Super Fitness
Blue
DQEvents
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First Name ___________________________ Last Name _______________________
Age ______ Sex ______
Address ________________________________
City ______________________________ State _______ Zip Code __________
Phone _____________________ Email ________________________________
Please check one of the following:
___ 5K ___ 1 Mile
___ Physically Challenged ___ Military ___ Emergency Services____
T-Shirt size: S ___ M ___ L ____ XL ____
IN CONSIDERATION FOR ACCEPTING THIS ENTRY, AND THE GRANTING OF THE RIGHT TO PARTICIPATE IN THIS EVENT, I, THE UNDERSIGNED, INTENDING TO BE LEGALLY BOUND, HEREBY FOR MYSELF, MY HEIRS, PERSONAL REPRESENTATIVES, SUCCESSORS, AND ASSIGNS, WAIVE AND RELEASE ANY AND ALL CLAIMS FOR LOSSES AND DAMAGES I MAY HAVE AGAINST, BREWERS TOWNE TAVERN, DOCKHOPPERS, COMMISSIONERS OF HADDON TWP., HADDON TWP., WESTMONT, THE POLICE DEPT. OF HADDON TWP., EVENT COMMITTEE, VOLUNTEERS, DQ EVENTS, THEIR REPRESENTATIVES, SUCCESSORS, AND ASSIGNS AND/OR ANY OTHER PERSON WHOMSOEVER FOR ANY AND ALL INJURIES, ILLNESS, INCLUDING DEATH, THAT MAY RESULT FROM MY PARTICIPATION IN SAID EVENT. I REPRESENT AND AFFIRM THAT I AM IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN THIS EVENT, AND VERIFIED BY A LICENSED PHYSICIAN, AND HAVE SUFFICIENTLY TRAINED FOR THE COMPLETION OF THIS EVENT.
THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNED THIS RELEASE
& WAIVER
X____________________________________ Date ________________
Make checks payable to: Haddon Township Turkey Trot
Mail Checks to:
Haddon
Township Turkey Trot
Po
Box 8865
Collingswood,
NJ 08108