New Jersey Firefighters 24th Annual Ski Race
Thursday February 10, 2011
Pre-Registration $60.00per person/$300.00 per tm Day of Race $70per person/$350 per tm
Department Name/Town ______________________________________________________
Address____________________________________________________________________
Telephone __________________________Unit# __________________________________
Is this an address change? __ Yes __ No
Email _________________________________
PRINT NAME SIGNATURE
1. __________________________________ ________________________________
2. __________________________________ ________________________________
3. __________________________________ ________________________________
4. __________________________________ ________________________________
5. __________________________________ ________________________________
In consideration of your accepting this entry, I hereby, for myself, my heirs, executors and administrators, waive and release any rights and claims for damages I may have against the New Jersey Firefighters Ski Race committee, their spouses, their representatives and successors, and Hidden Valley Ski Area for any and all injuries suffered by me or personal damage incurred in connection with said event. I certify that I am physically fit and have sufficiently trained for the completion of this race. I also give permission for the use of my name and/or picture in any newspaper, broadcast, telecast or any other account of this event.
PLEASE ENCLOSE FULL FEE OR MINIMUM $100 DEPOSIT WITH COMPLETED FORM.
MAKE CHECKS PAYABLE TO: NJFF SKI RACE
MAIL TO ARRIVE BEFORE: February 1, 2011 TO: Mark Ellerson
20 Long Acre, Cream Ridge, NJ 08514
EMAIL: NFFSKIRACE@AOL.COM, CCCHERYLD @ AOL.COM