THREADS & TREADS EVENT ENTRY FORM

TO COMPLETE THE ENTRY FORM FOR ALL RACES:SELECT the proper info in the fields marked "select", then print the form using the button below. After reading the agreement at the top, you must sign the form then mail or carry it to:
Threads & Treads, 17 East Putnam Avenue, Greenwich, CT 06830   (203) 661-0142
MAKE CHECKS PAYABLE TO THREADS & TREADS
NOW ACCEPTING ENTRIES BY FAX TO 203-661-0917. INCLUDE CREDIT CARD INFO BELOW
NOW  ALSO ACCEPTING ENTRIES VIA E MAIL ATTACHMENT TO mickeyyardis@yahoo.com

In Consideration of Acceptance of this entry, I the undersigned, intend to be legally bound, do hereby, for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I may have against any and all race sponsors, organizers, directors, event staff, volunteers, cities and towns in which the race is contested, their representatives, successors, and assigns, for any and all injuries suffered by me in said event.I attest and verify that I am physically fit and sufficiently trained for the completion of this event and my physical condition has been verified by a licensed Medical Doctor within the last six months. Further, I hereby grant permission any and all of the foregoing to use any photographs, videotapes, motion pictures, recording, or any other record of this event for any purpose whatsoever without compensation or remuneration.

ENTERING:        

LAST   NAME:        SEX:  

FIRST NAME:        AGE ON RACE DAY: 

BIRTH DATE:   Month:   Day: Year:

MAILING ADDRESS:

CITY:       STATE:     ZIP:

TELEPHONE:             T-SHIRT SIZE: 

FOR TOUR de GREENWICH ENTRIES,
ENTER ESTIMATED 20 MILE RIDE TIME: 

ADD YOURSELF TO OUR MAILING LIST?    YES:     NO:

YOUR E-MAIL ADDRESS:

CREDIT CARD # EXPIRATION:



PLEASE SIGN HERE: ______________________________________

If under 18, parent or guardian must sign.

YES, Count me IN for the following donation:

AMERICAN RED CROSS OF GREENWICH

 $_______

$_______

THANKS FOR ANOTHER
GREAT YEAR!

Check back soon to see what's coming up for our exciting 2013
season. See you there.