The 8th Annual
Andrea Holden
Thanksgiving Race
November 29, 2008
Saturday 10 AM

Home Race Map Registration Sponsor Form

Name: ________________________________________

Make Checks Payable to:
The Andrea Holden Thanksgiving Road Race
Mail to: The Andrea Holden Thanksgiving Road Race
            Box 542, South Dennis, MA 02660

Waiver: I know that running in a race can be a potentially hazardous activity. In consideration on my acceptance of this entry I intend to be legally bound hereby for myself, my heirs, executors, and administrators waive and release any and all rights, claims or other damages against Race Officials, Board of Directors, Sponsors, Volunteers, or the Town of Dennis or their agents. I also understand that there are no refunds of the circumstances including a cancellation due to poor weather directed by Race Officials. I also agree that all merchandise ordered and prizes won must be picked up on the day of the race.
Address: _____________________________________
City, St., Zip: __________________________________
Home Phone: __________________________________
Sex: _________________________________________
Age on Race Day: ______________________________
Category: __________ High School Competitor? (Yes or No)
Which High School? __________________ Must be enrolled.
D/Y Alumni Cup Competitor? (Yes or No) Year Graduated___
Recue Cup Competitor? Which Town's Team? ___________
Pre-Registration Fee: $15:00 / Family $50.00
Race Day Registration Fee: $20.00 / Family $55.00
T-Shirt Size: (M. L, XL) extra cost $10.00
2007 Hat extra cost $15.00
Total Amount enclosed:______________________

I would like to donate $___________ above the amount of the race, etc. to the Andrea Holden Foundation, Inc. All gifts are tax-deductible. All money raised goes entirely to the A.H.F.'s Mission. There are no paid persons or organizations.
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Signature                                Date
Signature (Parent/Gaurdian must sign if under 18)

Please print ths form for registration

For more information please contact Annie Gibbons at 508-385-7849