Registration Form 2017 Sprint to Flint

Sprint to Flint
FRIDAY, JUNE 16th
6:30pm 1M
7:15pm 5K
Pre-registration Advised
•! Pre-registration online discount!
•! Register online by accessing Race link at villageoflarchmont.org.
•! Or, Mail in the form below or drop at Village Clerk’s office in Village
Hall with your check payable to “Village of Larchmont” by June 9th.
•! Late registration and bib number / t-shirt pick-up at Flint Park
Playhouse: Thursday, June 15th 7-8pm AND Race day, Friday, June 16th
from 4:30-6:00pm
•! Registration will close if race reaches capacity. T-shirts guaranteed
to first 500 pre-registrants. T-shirts not guaranteed to registrants after June 9th.
No refunds or rain date for event.
Entry Fees: Save money by registering early & online!
Pre-registration Online:
$30.00 per adult $18.50 per youth
Paper Form (by mail –by June 9th)
$35.00 per adult $20.00 per youth
th
th
June 10 – 14 (Online only)
$35.00 per adult $23.50 per youth
Late Registration (June 15&16)
$40.00 per adult $25.00 per youth
(youth fees apply to ages 18 and under)
Great Family Event for Runners of All Ages!! Pizza and Music for Participants to Follow in Flint Park!
LARCHMONT RUN 2017 ENTRY FORM
Mail form and check payable to Village of Larchmont Run 2017, Village Hall, 120 Larchmont Ave., Larchmont, NY 10538
NAME: __________________________________________________________ (please complete one form per entry)
ADDRESS: __________________________________________________________ PHONE:_____________________
EMAIL: __________________________________________________________________________________________
AGE: ______ SEX: ______
Registration fee: ___________
CIRCLE EVENT:
5K RUN
1 MILE RUN
cash or check number ___________
CIRCLE T-SHIRT SIZE (Y=Youth, A= Adult):
YS
YM
YL
AS
AM
AL
AXL
“In consideration of the acceptance of my participation in this event, I do hereby release and discharge for myself, my heirs, executors, assigns and administrators, the
Village of Larchmont, Board of Trustees, all of the employees and officers of the Village, and all volunteers associated with this event from any claims or liabilities of any
sort whatsoever that may arise from any injury, illness, or damage I may suffer in connection with or as a result of my participation in this event.”
(Parent/Guardian signature is required
SIGNATURE: ___________________________________________________ if entrant is under 18 years of age)
THANKS
TO
OUR SPONSORS
GOLD
ACURA OF WESTCHESTER
CORNERSTONE OF LARCHMONT
DR. GARRETT WESTON, LARCHMONT ORTHODONTICS
LARCHMONT MAMARONECK YOUTH LACROSSE
LARCHMONT SOCCER CLUB
LUSARDI’S / CHAT 19
THE NEW JEWISH HOME, SARAH NEUMAN
THE ROSENBLUM TEAM AT JULIABFEE SIR
STOP & SHOP
SILVER
ADDISON STREET SPA, ANDORALAWNCARE.COM,
BURKE’S MAMARONECK OUTPATIENT CLINIC,
FOLEY’S TRUE VALUE HARDWARE, THE ICE CREAM PARLOUR,
MCMILLAN CONSTABILE FOSTER & PERONE, LLP,
LA RISERVA & TRATTORIA VIVOLO,
LARCHMONT MUSIC ACADEMY, MDXPRESS URGENT CARE
NEXT LEVEL CAMP FOR BOYS & NEXT LEVEL CAMP FOR GIRLS,
POST WINE & SPIRITS, PUSH FITNESS – MAMARONECK,
ONE2ONE BODYSCAPES PERSONAL TRAINING STUDIO,
SCHOOL OF ROCK MAMARONECK, VILLA MARIA PIZZA