2010 Registration

* Entry fee is per team.

ALL FIELDS ARE REQUIRED
First Name: Last Name:
Gender: -- choose -- Female Male
Birthday (yyyy-mm-dd): -- year -- 19201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999 - -- month -- 123456789101112 - -- day -- 12345678910111213141516171819202122232425262728293031
Street Address:
City/Town:  
Province/State:
Country:
Phone:
e-mail:

T-Shirt Size : -- choose -- Women's Small Women's Medium Women's Large Men's Small Men's Medium Men's Large Men's Xtra Large

ALL FIELDS ARE REQUIRED
First Name: Last Name:
Gender: -- choose -- Female Male
Birthday (yyyy-mm-dd): -- year -- 19201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999 - -- month -- 123456789101112 - -- day -- 12345678910111213141516171819202122232425262728293031
Street Address:
City/Town:  
Province/State:
Country:
Phone:
e-mail:

T-Shirt Size: -- choose -- Women's Small Women's Medium Women's Large Men's Small Men's Medium Men's Large Men's Xtra Large

ALL FIELDS ARE REQUIRED
First Name: Last Name:
Gender: -- choose -- Female Male
Birthday (yyyy-mm-dd): -- year -- 19201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999 - -- month -- 123456789101112 - -- day -- 12345678910111213141516171819202122232425262728293031
Street Address:
City/Town:  
Province/State:
Country:
Phone:
e-mail:

T-Shirt Size: -- choose -- Women's Small Women's Medium Women's Large Men's Small Men's Medium Men's Large Men's Xtra Large

ALL FIELDS ARE REQUIRED
First Name: Last Name:
Gender: -- choose -- Female Male
Birthday (yyyy-mm-dd): -- year -- 19201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999 - -- month -- 123456789101112 - -- day -- 12345678910111213141516171819202122232425262728293031
Street Address:
City/Town:  
Province/State:
Country:
Phone:
e-mail:

T-Shirt Size: -- choose -- Women's Small Women's Medium Women's Large Men's Small Men's Medium Men's Large Men's Xtra Large

I know that participating in physical fitness events is a potentially hazardous activity. I agree not to participate unless I am medically able and properly prepared. I should not participate without my physician’s approval. I agree to abide by any decision of an event official concerning my ability to safely participate. I assume any and all risks associated with the event; including but not limited to, falls, contact with other persons or objects, the effects of weather, traffic and course conditions. As a condition of my entering this event, I, for myself, any accompanying minors, and anyone entitled to act on my behalf, waive and release Beaudry Lemming Loop race (Dwayne Sandall), any associated or related entities, their directors, officers, employees, agents, representatives, sponsors, volunteers, and organizers (herein collectively called “Event Organizers”), from present and future claims and all liabilities of any kind, known or unknown, arising out of my participation in this event or related activities, even though such claim or liability may arise out of negligence or fault on the part of the Event Organizers. I agree that the Event Organizers shall not be liable for any personal injury, death or property loss, and I release the Event Organizers and waive all claims with respect thereto. In the event my registration fees are paid, I agree to be bound by the provisions of this waiver. I grant permission to Event Organizers to use or authorize others to use my personal information, any photographs, motion pictures, or any other record of my participation in this event or related activities without remuneration. Applications for minors shall be accepted only with a parent’s signature and should be signed by the minor. All entry fees are non-refundable. Transfers are allowed, please contact the race director one week prior to the event date.

I have read this Waiver. I understand and accept its terms. For relay teams, it is implied that this waiver applies to all team members.

Registration Cost Total: $00.00

Once you click register, you will be re-directed to PayPal to complete the payment. You can use a PayPal account or a credit card.