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Registration Forms



Salem Park and Recreation
7th Annual 5K Cross Country Run
March 22, at Olde Salem Greens Golf Course
9am start
Race benefits Salem Youth Bassketball and Salem High School Cross Country Teams
link for online registration

 








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Salem Park, Recreation & Community Services Department
Present:
The Derby Street Mile Run!
Friday, August 22,  2008   in Salem, Mass, 7:00pm
Race starts on Fort Ave & finishes at Pickering Wharf!
Entry fee: $12 pre-race day $15 on race day,  USTFA Certified code MA07017JK
Awesome Technical  short sleeve shirts given to first 175 entrants!!
Categories: Male & Female- Children (10 & under 14 & under), Youth (15-18), Open (19-29) (30-39), Masters (40-49), Senior Masters (50+), 60-69, 70 plus, First Salem resident
Awards & Prizes: Trophies to overall winners Male and Female
Medals given to top 5 finishers in each category, raffle prizes from local merchants.
Medals to top 3 male and female finishers from B&Sfitness programs
Post Race: refreshments, food, water, soda, fruit
Information: Contact the Salem Park, Recreation & Communty Services Dept (978) 744-0180 or
====================================================================================
In consideration of this entry being accepted, I hereby for myself, heirs, executers and administrators waive and hereby release any and all rights and claim for damages I may have against the City of Salem Park, Recreation and Community Services  Department of any and all injuries suffered at said event, while traveling to or returning therefrom
Name:_______________________________ Age:____ Male:__ Female:__

Address:_________________________________ City:___________ State:_________

Zip:__________Phone:_________________EMAIL:_______________
__ __________________________________ Date:_______tshirt size S__M__L__ XL___
Signature   (parent or guardian signature required if under 18 yrs of age)
Send registration & check to: Salem Park, Recreation and Community Services
5 Broad Street Salem, MA. 01970 c/o Derby Street Mile!



PROGRAM ______________________
    DATE _______________________________
   FEE ________________________________



Name ______________________________________________ Age ________________

Address ________________________________________________________________

Phone ______________________________ Emergency __________________________

E-mail __________________________________________________________________


                            Liability: The City of Salem Park, Recreation & Community Services Department, School Department and the instructors are not liable
                       for personal injuries or loss of, or damage to personal property. Since this is a physical activity, injuries may occur. Each student may
                        decline to participate in any activity and is also responsible to inform the instructor of any physical limitations, which may prevent full   
participation in the class.


Signature __________________________________________ Date _________________


Paid ____ Cash ____ Check ____

Please make checks payable to:
The City of Salem Park and Recreation Department
5 Broad Street
Salem, MA 01970



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Salem Park, Recreation & Community Services and the Boys & Girls Club of Salem
Present:
The   5th annual
Wild Turkey 5 Mile Run!”

Thanksgiving Day, November 27,  2008, @Boys and Girls Club 13 Hawthorne Blvd. 8:00 am
        
Pre-race packet pick up w/ numbers & shirt plus a chance to win a free pair of Brooks running shoes on November 25 & 26 from 10 a.m. –7 p.m. at:
New England Running Company, Commodore Plaza, 43 Enon St., Beverly
or pick up race day from 7 a.m. at Boys & Girls Club, 13 Hawthorne Blvd., Salem

Entry Fee: $20 pre-race day $24 on race day

Register Early: Awesome Long Sleeve Brooks Technical Shirts for first 750 entrants!
USTAF course  certification
Awards: Overall winner male and female,  top three Males & Females in each category: 14 & under, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70 & over
Post Race: refreshment, awards and raffles
Info: Salem Park, Recreation & Community Services (978) 744-0180 or
Sponsors: Brooks Sporting Co. New England Running Company, B&S Fitness, Perry & Perry Attorneys at Law, Eagle Tribune Publications, Butterworth & O’Toole, Inc, Poland Springs, Dunkin Donuts Baskin Robbins, Paul Herrick Group-Williams Realty,  Boston Herald, Stephen M. O’Grady Foundation, Salem State College, DeIulis Construction, Patrick Curtin D.D.S., O’Rourke Bros. Memorials, Gorilla Printing, Serafini, Serafini, Darling & Correnti, LLP, A&A Services, The Salem Inn, Toomey Sports Therapy, Crosby’s Marketplace, Eastern Bank Charitable Foundation, Seaport Credit Union, Beverly Franco American Club, Salem Common Neighborhood Association, Community Phonebook Company, Wire4Hire, Wicked Running Club, tuttle&co, Ninety-Nine Restaurant, CB Photography, Alix & Jasmine Bryant, Hillcrest Chevrolet of Salem, Ouellette & Smith-Fishlaw.com
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Name:_____________________________________________ Age:____ Male:_____ Female:_____
Address:__________________________________________ City:______________ State:________
Zip:___________Phone:____________________EMAIL:__________________________________
Date:__________________________         Shirt Size:   S___M___L___ XL__
Signature__________________________________________________________________________
(parent or guardian signature required if under 18yrs of age)
Send registration and check to: Salem Park, Recreation & Community Services, 5 Broad St. Salem, MA 01970 c/o Wild Turkey Run! Proceeds from the Wild Turkey support Salem youth programs.
In consideration of this entry being accepted, I hereby for myself, heirs, executers and administrators waive and hereby release any and all rights and claim for damages I may have against the City of Salem Park, Recreation & Community Services, Boys and Girls Club of Salem of any and all injuries suffered at said event, while traveling to or returning therefrom.   



















Salem City Hall 93 Washington Street, Salem, MA 01970
Phone: 978-745-9595
   City Hall Hours of Operation: Monday, Tuesday & Wednesday 8AM - 4PM Thursday 8AM - 7PM Friday 8AM - 12PM