TEAM NAME:  ____________________________________________________________

CAPTAIN:    ____________________________________________________________

DIVISION:(circle one)

OPEN MEN

M


MEN MASTERS (OVER 40)

S


MEN SENIORS (OVER 50)

P


BOYS HIGH SCHOOL

B


GIRLS HIGH SCHOOL

G


WOMEN OPEN

W


WOMEN MASTERS (OVER 40)

L


WOMEN SENIORS (OVER 50)

Y


VETERANS (OVER 60)

Z


CO-ED (2 MALE & 2 FEMALE)

C




LEG 1:___________________________________LEG 3:______________________________________

LEG 2:___________________________________LEG 4:______________________________________

I hereby waive and release all claims for damages that I may incur
as a result of race participation against the City of Lynn, the North
Medford Club, the Lynn AC, and any and all sponsors.

TEAM CAPTAIN:___________________________________________________________ 
ADDRESS:     ___________________________________________________________ 
CITY:        ______________________________ STATE:______ ZIP:___________