Name:    Age (as of 12/2/08):

Street Address:    City:    State:    Zip:

Phone:    E-Mail:    Team:

Shirt Size: --Select One-- Adult S Adult M Adult L Adult XL

In consideration of this entry, I waive all claims for myself and my heirs against any race official or sponsor for injury or illness which may directly or indirectly result from my participation. I further state that I am in proper physical condition to participate in the event and grant race officials and sponsors permission to take and use photographs or any other record of the event for any legitimate purpose.

By submitting this online registration form, you are indicating that you have read and agree with the conditions above.