2009 Rockledge Rumble Entry Form

NAME__________________________________________________

50K ($55*)______ 30K ($45*)______ 15K ($40*)______
*Each entry fee will increase by $10 on November 9; Registration closes on November 11.

ADDRESS___________________________________________________________________________

CITY___________________________________STATE____________ZIP CODE_________________

AGE_____SEX____SHIRT SIZE____PHONE #_____________________  EMAIL_______________________________


I DON'T PLAN TO RUN THE RACE, BUT WILL WORK AS A VOLUNTEER: ______ (put a check here, or send an email to our volunteer coordinator if you would like to help out at the Rumble)

Make check payable to "North Texas Trail Runners" and mail to
Dave Billman • 1110 Misty Oak Lane •  Keller, TX 76248

In consideration of the acceptance of this entry, I assume full and complete responsibility for any injury or illness which  may directly or indirectly result from my participation in the Rockledge Rumble; and I hereby release and hold harmless the directors, sponsors, promoters, officials and all persons and entities associated with the event from any and  all injury or damages. I state that I run at my own risk.

SIGNATURE:__________________________________________ DATE:_________________


NOTE:  There is a NO REFUND policy on all race registrations.