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2010 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 _______________________________
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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 _______________________ |
