Non-refundable Entry Fee:
$22.00 ($27.00 after Oct 1st)
Canadiens: Please pay in US dollars only (a money order is acceptable)
GMAA members, please subtract $1

Check or Money Order payable to the Green Mountain Athletic Association

Last Name: _________________________ First Name:  _____________________

Address:   _________________________ City/St/Zip: _____________________

Phone:     _________________________ E-Mail:      _____________________

BIRTHDATE: ___/___/___   AGE ON RACEDAY:______    GENDER:______

GMAA member:  yes  no  (Circle one)      Marathon Personal Best:_______

I would like to join the GMAA:  yes  no  (add $10 individual/$15 family)

T-Shirt Size (circle one)  Small Med  Large  XL

Waiver in the Event of Injury: On consideration of your accepting this entry, I hereby for myself and my heirs, executors and administrators, waive and release any and all rights and claims of damage I may have against THE GREEN MOUNTAIN ATHLETIC ASSOCIATION and all parties involved in the race organization(sponsors,directors,staff, towns,RRCA, or USATF), their successors and assigns, for any and all injuries suffered by me in this race or athletic event. I agree to follow all GMAA and RRCA rules, including not using skates, bicycles, skateboards, baby  joggers, or radio headsets and not running with a dog. I agree not to attempt to run the full marathon unless I am at least 16 years old.

Signature(s): __________________________________________ DATE: ________
                          Competitor's signature
              __________________________________________
             Parent's signature if competitor is under 18

                                                   TOTAL PAID: ________
Mail to:
  GMAA Green Mountain Marathon
  PO Box 194
  Essex Junction, VT 05453
E-mail: gmm@gmaa.net