PR Moose Milers Racing Team Application

Address: __________________________________________Age: _______ 

City: ______________________   State: ____   Zip Code: _______________

Evening Phone #: _________________   Day Phone #: __________________

E-Mail Address: ________________________________________________

Qualifying Race & Time: __________________________________________

Membership is free, but tax deductible donations are encouraged. We are a non- profit organization.

I know that running is a potentially hazardous activity. I should not enter and run in club activities unless I am medically able and properly trained. I agree to abide by any decision of a club official relative to my ability to safely complete a given race or training run. Knowing these facts, and in consideration of your accepting my membership application, hereby for myself, my heirs, executors, administrators or anyone else who might claim on my behalf, convenant not to sue, and waive, release, and discharge the Moose Milers & Marathoners, Inc. including their agents, employees, assigns, or anyone acting on their behalf, from any and all claims of liability for death, personal injury or property damage of any kind or nature whatsoever arising out of, or in the couse of, my membership in this club. This Release and Waiver extends to all claims of every kind or nature whatsoever, foreseen or unforeseen, known or unknown.

Signature: __________________________________   Date: _____________

Mail to: PR Moose Milers Racing Team, 160 Amherst Road, Merrimack, NH 03054

Qualifying Times

You must submit a printout of a race result since January 1, 2000 showing that you have met one of the qualifying times below. Please highlight your result in the printout. These results are for ages 19-35. If you do not have a qualifying time at one of these distances, but feel that your time at a different distance is comparable enter your best time in the WAVA Calculator to see if your equivalent time meets these guidelines. Call the Racing Team Manager if you have any questions.

If you do not have a qualifying time, but have run at least 5 races over the past 6 months or 8 races over the past year AND you have been invited to join the team by a current member, you can join the team by filling out this application and listing the races you have run to qualify.