2009 New England 1000

ENTRY FORM

 

 

 

 

Name __________________________________________________________ Phone No (_____ ) _________________________

Address _________________________________________________________________________________________________

City _________________________________________________ State ________________________ Zip ___________________

Bike Make ___________________________ Model ______________________ Year ___________________ Size ____________

 

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FEES

New England 1000 Entry Fee - Augusta, Maine Start $25.00; Other Start $35.00 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   _________

IBA SaddleSore 1000 Option - $20.00               Yes           No  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   _________

 

                 Make Check Payable to: Ed Farrell                                                                                                          Total              ________

 

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                                                                    START                                                                                         FINISH

                                  Odometer __________________________                       Odometer ___________________________

                                  Time ______________________________                       Time _______________________________

                                  Date ______________________________                       Date _______________________________

 

___________________________________________________________________________________________________________

 

 

CONDITIONS OF PARTICIPATION

 

I have read, understand and will comply with the rules of this event.

 

I hereby acknowledge that I am aware that there may be some danger related to motorcycle riding, including riding a motorcycle in an organized, touring event on U.S. highways. I voluntarily and knowingly assume all the risks, and agree to hold harmless the New England 1000 Run and/or its officers, sponsors and agents, if I or my property are injured or damaged. I also further understand that this waiver includes traveling to and returning from this event.

 

 

Entrant's Signature ______________________________________ Date _______________________