Murdick's Run the Chop Challenge Entry Form Name_____________________________________ Address___________________________________ City___________________________ State_______ Zip_____________ Phone_______________________________ Age on race day__________ Date of birth___________ Sex_________ Clydesdale (male 190+)     Filly (female 140+) T-shirt size__________________ Inconsideration of this entry being accepted, I hereby, for myself and my heirs, executors or administrators, waive and release all rights and claims for damages I may have against Murdick's Fudge of M.V., the Town of Tisbury and any and all sponsors for any and all injuries incurred before, during or after Murdick's 5 Mile Run the Chop Challenge. Signature_____________________________________________ (Parent/Guardian must sign if athlete is under 18 years old.)