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2010 New England 2000 ENTRY FORM
Name ____________________________________________Phone No (_____ ) ___________________ Address _____________________________________________________________________________ City _________________________________________ State ______________ Zip ________________ Bike Make _____________________ Model _______________ Year ____________ Size ____________ ____________________________________________________________________________________
FEES
New England 2000 Entry Fee - Augusta, Maine Start $35.00; Other Start $45.00 . . . . . . . . . . _________ IBA SaddleSore 2000 Option - $20.00 Yes No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _________
Make Check Payable to: Ed Farrell Total _________ ____________________________________________________________________________________
First NE1000 Second NE1000 START FINISH 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 2000 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 _______________________
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