SEPTEMBER 30TH OCTOBER 1, 2006
Address___________________________City_________________State____Zip_____
Phone___________________________Running Club______________________
Gender______Date of birth______________Best 24 hour distance______________
Emergency contact_______________________Emergency phone_______________
E-Mail address___________________________________Shirt size________
Waiver and release: I agree to release all race organizers, race officials, volunteers, and any other groups, agencies, or individuals involved in this event from all liabilities, claims, or demands for damages incurred by my participation in the Hinson lake 24 hour run or any of it's related parts. I realize that participating in an ultra event is a sometimes risky and potentially hazardous endeavor and assume all responsibilities for my participation. I certify that I am properly trained and medically able to paricipate in this event. I realize that the race director has the right to refuse entry or cease my participation in this event at any time at his discretion.
Signature_________________________________________Date_____________
(Parent or guardian if under 18)
Make check payable and mail tthe completed entry form to:
Tom Gabell
313 Louise Avenue
Rockingham, North Carolina 28379
Thank you for running happy and healthy!!!!!!!