Print this registration form and mail it to pre-register
Last Name
First Name
Company
Address, City,
State,
Zip
E-mail
Day Phone
Evening Phone
Team Name
WAIVER: In consideration
of your accepting this entry, I, intending to be legally
bound, do hereby for myself and my heirs, executors, administrators
waive and release any and all rights and claims or damages I may
accrue against the persons and organizations affiliated with the
race, for any and all injuries that may be suffered by me or en
route to or from the event. I attest that I am physically fit
and sufficiently trained for this competition, my physical condition
verified by a licensed M.D. during the last six months. As
part of the waiver, I acknowledge that I have read and understood
all of the above.
Signature__________________________________Date:__________ ALL ENTRANTS MUST SIGN WAIVER. (Parent/Guardian if
under 18.)
