Team Name:
___________________________________ Team
Captain:___________________________
Important Due Dates:
April 1 – Returning
team entry priority, must be received by the 1st.
May 1 – Entry deadline
and final shirt sizes due
June 1 – Team rosters
complete with participant name, age gender and waiver signature
Address:
__________________________________________________________________________________
City:
___________________________________________________ State: _____________ Zip:
____________
Phone:
(________)___________-_______________ e-mail:
__________________________________________
Make checks payable
to: North Country Trail Relay
Mail to: North
Country Trail Relay, C/o Brian Buchanan, 5075 Coltons Run, West Olive, MI 49460
Entry subject to
acceptance by race organizers and field size. Correspondence containing race
updates will be sent via e-mail to the team captain if an e-mail address is
provided.
Entry
fee $300.00
Charge for second
vehicle $30.00 _________
Teams using only one
vehicle will be entered into a drawing for a discount on the next year’s race.
Additional shirts for
support crew: _____ @
$14.00 each __________
Additional post race
party for support crew: _____ @ $4.00 each __________
Additional voluntary
donation to the Alzheimer’s Association
__________
Total $ __________
Teams that ran the prior year race will have until April 1 to
submit their entry and reserve their spot for the current year race. Open spots
for additional teams will be awarded on a first come basis. Entire roster need not be completed with
initial entry and payment. Team roster accompanied with a signed waiver for
each participant must be received by June 1, 2006. Last minute
changes/substitutions to team will be accepted up to the start of the
race. Changes in shirt sizes may not be
made after the May 1st entry deadline. Teams who fail to submit
shirt sizes by the deadline will receive the following men’s sizing shirts: 1
small, 2 medium, 2 large and 1 XL.
Waiver/Team
Roster
Waiver (must be
signed by entrant, parent or guardian): I know that running a race is a
potentially hazardous activity and I should not enter this event unless I am
medically able and properly trained. I realize the course for the North Country
Trail Relay presents a number of potential dangers to me and I assume all risks
associated with participating in this event. I realize I may encounter extreme
temperatures and I will be running on a number of different surfaces, such as
but not limited to, river crossings, roads and road crossings, steep hills, and
unimproved trails. The roads are open to motor vehicle traffic that has the
right of way. In consideration of your accepting my entry, I for myself, my
executors, administrators, assignees and anyone entitled to act on my behalf,
waive and release the organizers, volunteers and all other sponsors from all
claims of liabilities, actions, demands or damages of any kind arising out of
my training or participation in this event.
Runner Name (please print) Age Gender Signature (parent or guardian if under 18) Date
1. __________________________________ ____ _____ __________________________ ________
2. __________________________________ ____ _____ __________________________ ________
3. __________________________________ ____ _____ __________________________ ________
4. __________________________________ ____ _____ __________________________ ________
5. __________________________________ ____ _____ ___________________________ ________
6. __________________________________ ____ _____ ___________________________ ________
Number of shirts: Men’s
Coolmax Small _______ Medium ________ Large ________ X
Large _________
Number of shirts: Women’s
Coolmax Small _______ Medium ________ Large ________ X
Large _________
Number of shirts: Sport
Shirts Small _______ Medium ________ Large ________ X
Large _________
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