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Bernie’s Run Road Race Entry Form

Bernie’s Run
Hosted by The Village Manor
Proceeds to benefit the Dedham Education Foundation
DATE: Sunday, October 4, 2009
TIME: 11:00am — Registration by 10:45 AM.
COURSE: 5 KM Accurate Mile Markers and splits,waterstop
The course is primarily flat. NO SPRAGUE STREET HILL, WE PROMISE!
ENTRY FEE: $ 18 Pre-entry / $20 day of the race
Numbers may be picked up the day of the race.
Proceeds to benefit the Dedham Education Foundation
T-SHIRTS: Commemorative shirts to the first 150 entries.
Post-race refreshments include considerable food and beverages.
AWARDS: Top 3 Female and Male Open, Top 3 Masters (40 yrs or older)
Top Male and Female Youth (18 yrs. or younger)
Bernie’s Run is limited to the first 300 registered runners
PLEASE FILL OUT ENTRY FORM COMPLETELY.
In consideration of this entry being accepted, I hereby waive and release all right and claim for damages I may have against USATF, The
Dedham Education Foundation and The Village Manor and anyone associated with the above mentioned; any & all injuries sustained by
me at said event or while traveling to and from said event. This race is sanctioned by the USATF.
Name:__________________________________
Address:____________________________________________________________
# & St. Town/City Zip
Tel. #:_________________________________ Club/School:____________________
Sex: F_____ M_____ Age:______ Signature:____________________________
Checks Payable To: The Dedham Education Foundation
Mail to: The Village Manor, 427 Sprague Street, Dedham, MA 02026
Information:
www.thevillagemanor.com

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