REGISTRATION FORM

CIRCLE RACE:  

    100K...   50K...   or    25K...  for the INDIVIDUAL RACES

Age on Race Day:______  Gender:________

....100K RELAY(4 person) check division... co-ed___...men___....women___

 (PLEASE SEND IN RELAY ENTRIES TOGETHER)

PRINT NAME:___________________________________

TEAM NAME if in RELAY:__________________________

ADDRESS:_____________________________________

CITY:_________________STATE:_______ZIP:________

EMAIL ADDRESS:_______________________________

***you will be contacted by email to confirm your entry***

PHONE#:______________________________________

CIRCLE THE APPROPIATE SIZE: 

INDIVIDUAL RUN: 100K or 50K cost is $100.00

....  100K or 50K   JACKET SIZE: ...SM,...MED.,...LG.,..XL,..XXL

       25K Run COST is $30.00 Long Sleeve Shirt Size:  sm...med...lg....xl

   RELAY TEAM ENTRY FEE...cost is $25 per person x 4 = $100.00

   RELAY T-SHIRT SIZE: ...SM.,...MED.,...LG.,...XL

ALL RACERS must Pre-Register

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MAKE CHECKS PAYABLE and MAIL ENTRY FORM/FORMS TO:

OLD FARTS RUNNING CLUB, 2010 WOODRUN, LOWELL, MI, 49331

SIGN and DATE RACE WAIVER:

BY ENTERING THIS RACE I RELEASE ANY AND ALL LIABILITY, RIGHTS AND CLAIMS AGAINST AND/OR TOWARDS THE RACE DIRECTORS, SPONSORS, HOST SITE, ETC. I AM FULLY AWARE THAT THERE ARE RISKS IN RUNNING ON TRAILS, ROADS, ETC. AND THAT THIS IS A VERY LONG RACE THAT IN THE FACT ALONE IS A RISK. I HAVE CONDITIONED MYSELF TO THE APPROPIATE LEVEL OF FITNESS AND WILL ABIDE BY ALL RACE DIRECTORS DECISIONS SHOULD THEY FEEL THAT I AM PUTTING MYSELF AT RISK AND THAT THERE ARE INHERENT DANGER WITH TRAIL RUNNING THROUGH REMOTE COUNTRY WITH MINIMAL MEDICAL AID AND DO ACCEPT THE ABOVE LIMITATIONS.

SIGN:________________________DATE:_________________AGE______ GENDER_____________