ALLISON, ARKANSAS

 

 

FEBRUARY 21, 2004

7:00 A.M. START

 

NAME:_____________________________________________________________________________________

                              LAST                                                         FIRST                                               MIDDLE

 

ADDRESS:__________________________________________________________________________________________

                               P.O.BOX/STREET                                  CITY                           STATE                                   ZIPCODE                              

 

TELEPHONE: ____________________ BIRTHDAY: ____/___/___/   AGE AS OF 2-21-04: _______________

 

SEX: M___/F___ SHIRT SIZE S__

                                                    M__

                                                     L __

                                                   XL__

 

EMAIL ADDRESS: ___________________________________________

 

ENTRY FEE: $30.00 PRIOR TO FEBRUARY 14, 2004, $40 THEREAFTER.  SORRY, NO REFUNDS!!!!

RACEDAY SHIRT GUARNTEES UNTIL FEBRUARY 18.  OTHERS WILL BE MAILED.

 

                                                                         RELEASE AND WAIVER

 

To participate, I will accept all rules, conditions, and regulations and agree to comply with them.  The race director(s) or designated personnel has the right to stop any participant who in their opinion is not fit to continue.  This entry contains a release and waiver.  Signing does away with any claim of injury.  No entry will be accepted without a signature.  In consideration of the acceptance of my entry, I for myself, my executors, heirs, administrators, and assigns do hereby release and discharge the “SYLAMORE TRAIL 50K”, all sponsors, and all volunteer groups or individuals.  I am physically fit and sufficiently trained to participate in this endurance event and assume all risk of participation.  I understand that some trails and roads may be open to traffic and I am responsible for my safety.

 

 

SIGNATURE: ___________________________________DATE: __________________________

                      PARENT OR GUARDIAN IF PARTICIPANT IS UNDER 18

 

 

MAKE CHECKS PAYABLE TO:  SYLAMORE TRAIL 50K

 

 

RETURN SIGNED APPLICATION TO:  RANDY DAVIDSON

                                                                      20208 DWIGHT LITTLE ROAD

                                                                      ROLAND, ARKANSAS 72135

 

QUESTIONS?  EMAIL SYLAMORE50K@AOL.COM (NOTE EMAIL ADDRESS CHANGE!!!)

 (PREFERRED)

OR CALL 501-868-5555

 

NO DAY OF RACE SIGNUP.