Run4therolls

Send registration to: Chelsea Recreation 510 E Washington, Chelsea,Mi. 48118

Packet Pickup/ Race day Registration: Corner of Taylor and Old US 12 by Fair Grounds

Bag drop off area by registration table ( not responsible for lost or stolen items) Finish line towels

Please Circle: Event Sex Shirt Size

Name__________________________________________________Age_______ RUN WALK M / F YM YL S M L XL

Address_____________________________________________________________________________________________________________

City, State, Zip,_______________________________________________________________________________________________________ Phone___________________EMAIL______________________________________________________________________________________

Wavier: I certify that I am physically fit to participate in this event. I recognize that the sponsors, their agents and promoters cannot and do not assure my safety during my involvement in this event as the course is on a public roadway. I assume all risks of accident and injury before, during and after the event in consideration for my entry into this event. I waive all rights and claims I or my estate may have or acquire arising from my participation in this event. I further pledge to hold harmless and indemnify the sponsors, their agents, Chelsea Community Fair, City of Chelsea, Chelsea Fire Dept.,

Chelsea Community Hospital, Chelsea Recreation, Common Grill. from liability or damages as a result of my participation in the Run for the Rolls race.

___________________________________________________________________________Date_____________________________

Signature of Participant: (Under 18 years of age requires guardian signature)

Make Checks payable to: Chelsea Recreation / Roll Proceeds Benefit: Chelsea Recreation Youth Scholarships.