Faxon Law Fairfield HalfMarathon, 5K & Kids Fun Run
Until 1/18 / 1/19-2/15 / 2/16- 4/14 / 4/15 – 6/24 / Raceday Entry(If Available)
Half MarathonAdult / $50 / $55 / $60 / $65 / $70
Half MarathonStudent
(18under) / $40 / $45 / $50 / $55 / $60
5KAdult / $27 / $28 / $30 / $32 / $35
5K Student
(18under) / $17 / $18 / $20 / $25 / $30
Lucas Challenge
5k & Half Marathon / $83 / $83 / $95 / $102 / $105
Lucas Challenge
5k & Half Marathon
Student (18 & under) / $63 / $63 / $75 / $82 / $90
Kids Fun Run (under 12) / $8 / $9 / $10 / $10 / $12
T-Shirt Size Unisex (Please Circle): XS S M L XL
Event: Half Marathon 5KLucas ChallengeKids Fun Run
If applicable: Police Fire Department: ______
Mail my packet (if received by 6/1, additional $12):
Mail to:Fairfield Half Marathon Inc.
2 Buena Vista Road
Branford, CT06405
Last NameFirst Name
Address
CityStateZip
Age______MaleFemaleDate of Birth: / /
WAIVER: I know that running a road race is potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I also know that, although police protection will be provided, there will be traffic on the course route. I assume the risk of running in traffic. I also assume any and all other risks associated with running this event including but not limited to falls, contact with other participants, the effects of weather, including high heat and/or humidity, and the condition of the roads, all such risks being known and appreciated by me. Knowing these facts and in consideration of your accepting my entry fee, I hereby, for myself, my heirs, executors, administrators or anyone else who might claim on my behalf, covenant not to sue, and waive, release, and discharge the Town of Fairfield, Town of Westport, The Fairfield Half Marathon Inc., Anthem Blue Cross and Blue Shield of Connecticut, John Bysiewicz, JB Sports LLC, the Fairfield Police Department, Westport Police Department, Race Officials, The Hole in the Wall Gang, employees, Volunteers, any and all sponsors including their agents, employees, assigns or anyone acting on their behalf, from any and all claims or liability for death, personal injury or property damage of any kind or nature whatsoever arising out of, or in the course of, my participation in this event. This Release and Waiver extends to all claims of every kind or nature whatsoever, foreseen and unforeseen, known and unknown. The undersigned further grants full permission to The Fairfield Half Marathon Inc. and/or agents authorized by them, to use any photographs, videotapes, motion pictures, recording, or any other record of this event for any purpose. Application for minors under 18 will be accepted only with a parent's signature.
Signature (Parent must sign if competitor is under 18 years of age)Date