Manchester City Marathon, Half Marathon and Relay OFFICIAL ENTRY FORM

Manchester City Marathon, Half Marathon and Relay
OFFICIAL ENTRY FORM
Sunday, November 2, 2014
USATF New England Championship
One person per entry form, this form may be duplicated
Mail-in entry deadline for all events is 10/23/2014
No Refunds or Transfers
BOTH PAGES MUST BE RETURNED
First Name
Last Name
Gender (Circle)
M
Age on 11/03/13
DOB (Mo/Day/Year)
F
/
Race (Circle)
FULL
/
HALF
RELAY
Shirt Size (circle)
FEMALE
XS
S
M
L
XL
Is this your first marathon/ half?
YES
/
NO
MALE
S
M
L
XL
XXL
Anticipated Time
(circle)
:
Street Address
City
State
Zip Code
Email Address (will get race news and updates)
Daytime Phone
Evening Phone
(
)
-
Emergency Contact First Name
(
)
-
Emergency Contact Last Name
Daytime Phone
(
)
-
Would you like a text message of your finishing time?
YES
NO
(circle)
If yes, please provide your cell phone number:
(
)
-
USATF – NEW ENGLAND MARATHON CHAMPIONSHIP
www.usatfne.org
THIS COURSE IS USATF CERTIFIED AND SANCTIONED
Club Name
10 digit USATF number
3 digit club number
Team scoring requirement and USATF –
NE Grand Prix guidelines may be found
at: www.usatfne.org/road/gp
Review and sign waiver
In consideration of this entry being accepted, I, for my heirs, executors, assigns, personal
representatives, and administrators, waive and release any and all claims for personal injury and
damages I may have against the organizers, City of Manchester, sponsors of this race, and
volunteers. USATF, USATF New England and all of its officers and/or representatives shall be free
from any liabilities or claims for damages arising by reason of injuries to anyone during this event. I
attest and verify that I am physically fit and have sufficiently trained for this event. I freely and
voluntarily accept responsibility for all risks including death, personal damages and injury, and
personal property damage and loss that may occur prior to, during, and after this event. I voluntarily
participate in this event in recognition of—and in spite of—all associated risks with running this event,
including, but not limited to, falls, contact with other participants, the effects of weather, including
cold, heat, and rain or snow; traffic and surface road conditions and human error by volunteers or
race officials. I understand that roller skates or blades, bicycles, baby joggers, animals, and
skateboards are prohibited from the race and I will abide by the guideline. Moreover, I understand
that the Manchester City Marathon and those authorized by the Manchester City Marathon and Half
Marathon will be taking photographs, and making audio and video recordings of the participants,
races and related events. I hereby irrevocably consent to, and grant use of, all photographs and
recordings, digital and otherwise that contain my person, image, likeness, or name and voice, for any
lawful purpose including news reports and event promotions.
SIGNATURE OF PARTICIPANT *
* If under 18 years of age, parent or
guardian signature is required
DATE
Only runners with current USATF membership prior to the start of the race are eligible to receive prize
money. Foreign athletes must be eligible under IAAF and their home country federation’s rules to be
eligible to receive prize money. To be eligible to score as an individual or as a member of a team in the
USATF-NE Championship and to be scored as a Grand Prix Ironrunner, a runner must be a current
USATF member in the New England Association as of the start of the race. Proof of current USATF
membership must be submitted before the race by including their membership number on the entry
form.
All other entrants are encouraged to register with the USATF-NE or their local USATF Association. To
register, contact the New England Association, USATF, P.O. Box 1905, Brookline, MA 02146, 617-5667600. You may also register on line at www.usatfne.org. A USATF-NE representative will be present at
race headquarters on Saturday to register athletes.
MAIL ENTRIES INCLUDING CHECK TO:
MANCHESTER MARATHON ASSOCIATION
P.O. BOX 933
MANCHESTER, NH, 03105
Entry Fee
Enter By
MARATHON
HALF
MARATHON
RELAY
July 31,2014
$75.00
$65.00
$160.00
HALF
MARATHON
RELAY
$80.00
Sept 30, 2014
$85.00
$75.00
$160.00
$80.00
After Sept 30, 2014
$95.00
$85.00
$160.00
$80.00