A p p l i c a t i o n
for the 2009 Delaware & Raritan Canal Paddlers' Race
Advanced registration is required
Canoe Kayak male female mixed
The color of my boat is   I am a
with an expected time of:
Solo $
Name
Address
City
State ZIP
Phone
Email
Tandem $
and
Address
City
State ZIP
Phone
Email
Additional comments
Mail this with
your check
payable to: 		"Meadows Foundation"
c/o Carol Sas
80 Winston Drive
Somerset, NJ 08873

Delaware & Raritan Canal Paddlers' Race
RELEASE

In consideration of being entered in this race, I the undersigned intend to be legally bond hereby for myself, my heirs, executors, and administrators, wave and release the Meadows Foundation, race supervisors, volunteers, D&R Canal Commission , State of New Jersey and sponsors for any and all injuries suffered by me in this event. I attest and verify that I am physically fit, and sufficiently trained for the completion of this event. I hereby grant full permission to any and all of the foregoing to use any photographs, video tapes, motion pictures, or any other recording or any other record of this event for any legitimate purpose.

Signed _________________________________ Date ___________

Print Name: _________________________________


Signed _________________________________ Date ___________

Print Name: _________________________________