The Dryden Puddle; Paddle &Run

Registration Form 2010

BIBB #
________________________________________ ___________ _____________first time Biathlete
NAME OF FIRST TEAM MEMBER OR INDIVIDUAL AGE SEX

_________________________________________ ___________ or How many events in the last 3 years?__________

ADDRESS PHONE Shirt Size

Assigned in house _________________________________________ ___________ Small  Med  L  2x  3x

CITY STATE ZIP EMAIL

TEAM NAME if applicable:____________________________

BIBB #

________________________________________ ___________ _____________first time Biathlete
NAME OFSECOND TEAM MEMBER AGE SEX

_________________________________________ ___________ or How many events in the last 3 years?__________

ADDRESS PHONE Shirt Size
Assigned in house
_________________________________________ ___________ Small  Med  L  2x  3x
CITY STATE ZIP EMAIL

________________________________________ ___________ _____________first time Biathlete

BIBB # NAME OFSECOND TEAM MEMBER AGE SEX

_________________________________________ ___________ or How many events in the last 3 years?__________

ADDRESS PHONE Shirt Size
_________________________________________ ___________ Small  Med  L  2x  3x
Assigned In house CITY STATE ZIP EMAIL


2
Man Team Kayak & 5K $40.00
 All over 16 Competitive
Check out these links:

At least one under 16 www.mapmyrun.com Dryden Runs page 2 for maps
Family/semi- competitive
3 Man Team Canoe & 5K $60.00 www.drydenlakefest.org
 All over 16 Competitive
At least one under 16 www.Trifind.com Go to NY; look up August 14
Family/semi- competitive
Leave a message: dryden_lake_festival@gmail.com
Fun Run/ Canoe
 ½ mile Woods Fun Run 16 & under $10.00
Backward Firemen’s Race $20.00 Print your Registration Form and complete
Challenge Race vs??? $20.00 all that apply and send with check to:
Individual
Dryden Lake Festival Association
 Biathlon (w Kayak) $35.00 C/O Dryden Town Hall
 Competitive just Canoe $20.00 93 East Main St.
 Competitive just Kayak $20.00 Dryden, NY 13053 DEADLINE August 1
 Competitive just 5K $20.00
We need to rent a canoe The first 200 registrants will Please make Checks payable to

$25.00 pre-registration (limited no. of Kayaks reserve early)
$35.00 day of race Approved PFD must be worn
receive Biathlon Tank Tops at
sign in table the day of race
Dryden Lake Festival Association
include all fees and rentals

I__________________________________(print name of parent or legal guardian) release and
hold harmless the Town of Dryden, the Dryden Lake Festival Committee; its representatives and
event volunteers and any sponsors of this event and any and all rights and claims or personal
damages against the same (including costs and attorney fees) for bodily injury and or property
damage. I understand that participation in this event involves rigorous physical activity and risks
of physical injury and we assume these risks. I further attest to my awareness of the inherent
risks of an event of this nature being held in any weather as may present itself.
I_______________________________________(print name of participant) release and hold
harmless the Town of Dryden, the Dryden Lake Festival Committee; its representatives and event
volunteers and any sponsors of this event and any and all rights and claims or personal damages
against the same (including costs and attorney fees) for bodily injury and or property damage. I
understand that participation in this event involves rigorous physical activity and risks of physical
injury and we assume these risks. I further attest to my awareness of the inherent risks of an event of
this nature being held in any weather as may present itself.

I hereby give consent for emergency transportation and treatment in the event of illness or
injury. I hereby accept responsibility for the payment of any emergency transportation or
treatment on behalf of the participant.
I certify that ________________________________(print name of participant) is physically fit
and has trained for this event as a team member or individual participant.
I hereby give consent for emergency transportation and treatment in the event of illness or injury. I
hereby accept responsibility for the payment of any emergency transportation or treatment that might
be incurred and I certify that I am physically fit and have trained for this event as a team member or
individual participant.
________________________________(signature of participant)

________________________________(signature of parent or legal guardian) Make extra copies of release forms if necessary