In consideration of this entry form being accepted, I for myself, my heirs, administrators and assigns hereby waive and release and all rights and claims of nature that I may have against the sponsors of this race. Name: _____________________________ Age_____ DOB ___________ Telephone ____________________ Street _____________________________ City _________________ State ____ ZIP __________ Signature _______________________________________________________ ............. (Parent or Guardian signature for applicant under 18 years of age) .... Lisbon Recreation Department, 300 Lisbon Street, Lisbon, ME 04252 Questions? Call 207-353-2289 ext. 118 |
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