


Directions: Garden State Parkway to exit 69. Make a left off the exit ramp onto Route 532 west and go about 2 miles. Entrance is on your left.
1st place male & female finishers get a choice of Ratigan original Disney cell animation (from the movie The Great Mouse Detective - voiced by the late Vincent Price) or a Heineken Home Draft System (each worth aprox. $500.00) or Fishing trip for Four aboard the Gambler in Point Pleasant - fastest fishing boat on the east Coast - www.GamblerFishing.net or Trip for two on the River Ladypaddle wheel boat out of Toms River - www.riverlady.com
Awards to the first 3 male/female in each: 21-29, 30-39, 40-49, 50-59, 60-69, 70- + ); random rattie prizes
Name _________________________________________________________ Age______Sex_____
Street Address_______________________________ City________________ State_____ Zip_______
Phone________________________ E-Mail_____________________________ Check One 10K ____ 20K ____
Wind Shirt Size S___ M___ L___ XL___
RELEASE
I know that running a road race is a potentially hazardous activity and that I should not enter and run unless I am medically
able and properly trained. I agree to abide by any race official relative to my ability to safely complete the run. I assume all
risks associated with running this event including but not limited to : falls, contact with other participants, the effect of the
weather, including low or high temperatures and/or humidity, traffic and the conditions of the course, all such risks being
known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my
entry, I, myself and anyone entitled to act on my behalf, waive and release the Organizers, its Officers, Members and race
volunteers, Wells Mill Park, and all sponsors,
their representatives, employees and successors from any and all claims and liabilities of any kind arising out of my
participation in this event or carelessness of the persons named in this waiver. Further, I grant to all of the forgoing to use
any photographs, motion pictures, recordings or any other record of this event for legitimate purposes.
Signature_____________________________Date__________ Parent/ guardian if under 18.
Jersey Shore Running Club