2010 New England 1000

 

ENTRY FORM

 

 

 

Name _________________________________________ Phone No (_____ ) _____________________

Address _____________________________________________________________________________

City ______________________________________ State ______________ Zip ___________________

Bike Make _________________ Model ________________ Year ____________ Size _______________

 

____________________________________________________________________________________

 

FEES

 

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

IBA SaddleSore 1000 Option - $27.00     Yes        No  . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   ____________

 

             Make Check Payable to: Ed Farrell                                                              Total      ____________

 

____________________________________________________________________________________

 

                                       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 _______________________