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 - $27.00     Yes        No  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  _________

 

             Make Check Payable to: Ed Farrell                                                              Total             _________

____________________________________________________________________________________

 

First NE1000                                                                       Second NE1000

                           START               FINISH                                                      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 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 _______________________