1. 22900 Huron River Drive, New Boston, MI 48164
Jimmy Williams Memorial Run
Registration Form
Saturday, May 5, 2018
at 10am
at Willow Metropark
22900 Huron River Drive, New Boston, MI 48164
Event Cost:
Early Registration $25 – by April 21, 2018*
Late Registration $30 – between April 22 and May 4, 2018
Day of Race $35
*t-shirts available while supplies last after April 21st
Mail Entries to: Jimmy Williams Memorial Run
26070 Whispering Willows Drive
New Boston, MI 48164
Register Online at:
Name: _________________________________________
Address: _______________________________________
City: _____________ State: _____ Zip Code: _________
Telephone: ______________ ________________
Gender (M/F): ______ Age (on 5/5/18): ________
Select T-Shirt Size: YS YM YL S M L XL 2XL
In consideration of acceptance of my race entry, I, for myself, my executors, administrators, and assignees, do hereby release and discharge the Jimmy Williams Memorial Run/Scholarship, the City of New Boston, all sponsors, supporters, participants, and spectators for all claims of damages, demands, actions whatsoever in any manner arising from my participation in said event. I attest and verify that I have full knowledge of the risks involved in this athletic event, am physically fit to participate in this event, and have my physicians approval. Further, I hereby grant full permission to any of the aforementioned to use my photograph, videotape, film, motion picture, or record of my participation in this event.
Signature _____________________________________________________________
Parent Signature (if participant is under 18) _____________________________________