| Green Brook Racing LLC Joe Patanella, Race Director Race Application |
Name:_______________________________________ Age on 12/31/08:_________ DOB:__________ Address:_______________________________________________________________________________ Phone:_____________________ Sex: M F USAT # ___________ XTERRA ID # ______________ E-Mail address:______________________________________________________Shirt size: M L XL Amout enclosed: $ ______________________ NO REFUND OF TRANSFER |
| Mail this Application to: Green Brook Racing, LLC PO Box 825Green Brook New Jersey 08812-0825 Please make check payable toGreen Brook racing, LLC |
Patanella's King of the Hill Off- Road Triathlon a XTERRA Points Series Race May 18th, 2008 10:00 AM Male 5 year age groups Female 5 year age groups Clydesdale ( male over 200 LBS) Entry FEE: $ 70 Up to 30 days before $75 30 days before and day before race $ 80 race day $ 80 relay X2 $ 90 X3 $ 10 USAT fee for one day pass if not member. |
| Patanella's King of the Hill off- Road Duathlon May 18th 2008 10:00 AM Male 5 year age groups 20 to 50 yrs old Female 5 year age groups 20 to 50 yrs old Clydesdale ( Male over 200 LBS) Entry FEE: ALL RACERS MUST BE USAT MEMBER OR PAY $ 10 ONE DAY FEE $ 60 Up to 30 day before $ 65 30 Days before $ 70 race day Relay $ 80 X2 $ 90 X3 |
| *******************WAIVER******************* In consideration of this entry, I hereby signify my understanding that Green Brook Racing LLC and Round Valley Recreation area, and all other organization associated with this event are not held responsible for any injuries which I may suffer from the connection. I hereby waive any claims for damages to my person or property. I further attest to being physically capable of particiption in this event. Signature of participant:__________________________________________Date:____________________ Signature of parent or guardian under 18 yrs old:___________________________________________ Date:___________________________ |