SMUGGLERS' NOTCH
PRIMITIVE BIATHLON

JANUARY 24th & 25th, 2009

ENTRY FORM

NAME:____________________________________________________

ADDRESS:_________________________________________________

CITY:_____________________________STATE:_____ZIP:__________

COUNTRY:_________________

DAYTIME PHONE:___________________________________________

EVENING PHONE:___________________________________________

E-MAIL ADDRESS:___________________________________________

DATE OF BIRTH:____________

UNDER 18 REQUIRES PARENT OR GUARDIAN PERMISSION AT CHECK-IN

FOR ADVANCED ENTRIES ONLY:

PREFERRED DAY: SAT____ SUN____

PREFERRED START TIME(Between 8:00 and 2:00)____________________

PLEASE NOTE: WE WILL BE ASSIGNING START TIMES AS CLOSE AS POSSIBLE TO THOSE REQUESTED; PRIORITY WILL BE JUDGED BY DATE OF RECEIPT OF ENTRY.

IF YOU ARE COMING IN A GROUP, PLEASE SEND ALL ENTRIES TOGETHER, AS WE WILL ENDEAVOR TO ASSIGN CONSECUTIVE START TIMES.

ENTRY FEES: $10.00 IN ADVANCE, $15.00 DAY OF EVENT

SEND TO:

PRIMITIVE BIATHLON
PO BOX 276
JEFFERSONVILLE, VT 05464

IN THE EVENT OF A QUESTION REGARDING THE RULES OR RESULTS, THE DECISION OF THE ORGANIZERS WILL BE FINAL.

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