ELECTRONIC FILERS PLEASE SEE THE END OF THIS DOCUMENT

Please provide us with the following information:

		EMAIL ADDRESS  (electronically transmitted applications, only)
		____________________________________________________

		LAST NAME: _________________________________________

		FIRST NAME:_________________________________________

		ADDRESS: ___________________________________________

		CITY: _________________  STATE: _____  ZIP: ________

Male_______	Shirt size	S_______ M_______ L _______XL _______

Female_____	Home Phone# _________________ 

Age on September 12, 1998 __________


RELEASE

In consideration for being accepted as a participant in the athletic event
described above, I for myself, for my heirs, executors, administrators and
assigns agree to assume all risks associated with the athletic competition and
also agree that if I am injured or hurt in any way, that I will not make a
claim or bring suit against the Brielle Day Committee, all Brielle Officials,
employees, agents, coordinating groups, or any individuals associated with the
event (hereafter releases), its representatives, successors, and assigns. In
addition, I agree not to make any claim against releases for the loss or damage
of personal items which may be related to my participation in the athletic
competition described above.

I expressly waive all rights for claims and damages which I may have against
the releases, its representatives, successors and assigns and will hold them
harmless for any and all injuries suffered in connection with this event. I
have been warned that I must be in good health. In filling out this form, I
acknowledge I have fully read, and fully understood the Official Entry Form,
and understand my own liability and accept the restrictions described herein.

_____________________________________________________________________________

Signed (parent or guardian if applicant is under 18 years of age)

Date: ___________

To electronically file this application, Save this entire page, fill it out in a text editor, and use the "Send" link at the bottom of the page to attach the file. Non-graphical Web browsers (such as "lynx") will have to use a seperate Email program (such as "pine" or elm") to attach the file.

	Make checks payable to: Brielle Day Race Committe

	Mail to:
			Race Committee
			Borough Hall
			Union Lane
			Brielle, NJ   08730

ALL PRE-REGISTRATIONS NOT PAID BY SEPTEMBER 5, 1998 WILL BE DELETED