"Run, Chamberlain, Run" Race Preregistration
Runaway Pond 200th Anniversary Celebration
“Run, Chamberlain, Run” Road Race
Saturday, June 5, race starts at 9am
5.5 miles from Runaway Pond site along Rt. 16 to Glover Village
Sponsored by the Glover Historical Society PO Box 208 Glover, VT 05839
Name: _____________________________________
Address: ____________________________________
____________________________________
Phone: _____________________________________
Age on day of Race: ___________________________
___ Adult ___ Child ___ Runner ___ Walker
Registration Fee: Child - $10 , Adult - $15 includes commemorative T-shirt
I, the undersigned, do understand and agree that the sponsor, Glover Historical Society, nor any of its officers or members are liable for the health and well-being of the participant.
Participant Signature: _______________________________ Date: __________
(copy and paste into your word processor)