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The City of Social Circle Proudly Presents…

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The City of Social Circle Proudly Presents… XTERRA ALABAMA TRAIL RUN SERIES REGISTRATION FORM 2013-2014 FIRST NAME: ____________________________ LAST NAME:___________________________________ ADDRESS _________________ E-MAIL:_________________________________ CITY: STATE: ZIP: ________PHONE:______________ T-Shirt: WS WM WL XS S M L XL XXL Sex: M F D.O.B.______________(REQUIRED) Age Group: (Circle One) 14&U, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70-U REGISTRATION FEES PER EVENT – Check the box(es) of the registered event(s): (Dates On Left Column Are Regular Registration Fee – Dates On Right Column Are Late Fees) XTERRA RED MOUNTAIN PARK TRAIL RUN – 9/14/13 XTERRA OAK MOUNTAIN STATE PARK TRAIL RUN – 11/10/13 Red Mountain Park, Birmingham, Alabama Oak Mountain State Park, Pelham, Alabama [ ] 10.0 Mile [ ] 5.0 Mile [ ] 13.1 Mile [ ] 6.2 Mile [ ] 3.1 Mile 10.0 Mi through Sept 1, $35 Sept 2-Sept 12, $40 (LATE) 13.1 Mi through Oct 28, $35 Oct 29-Nov 8, $40 (LATE) 5.0 Mi through Sept 1, $30 Sept 2-Sept 12, $35 (LATE) 6.2 Mi through Oct 28, $30 Oct 29-Nov 8, $35 (LATE) 3.1 Mi through Oct 28, $25 Oct 29-Nov 8, $30 (LATE) XTERRA CHEAHA STATE PARK TRAIL RUN – 9/28/13 Cheaha State Park, Delta, Alabama XTERRA COLDWATER MOUNTAIN TRAIL RUN – 11/30/13 [ ]6.2 Mile Coldwater Mountain, Anniston, Alabama 6.2 Mi through Sept 15, $30 Sept 16-Sept.26, $35 (LATE) [ ] 9.6 Mile [ ] 2.4 Mile 9.6 Mi through Nov 14, $30 Nov 15-28, $35 (LATE) XTERRA HENRY FARM PARK TRAIL RUN – 10/19/13 2.4 Mi through Nov 14, $25 Nov 15-28, $30 (LATE) Henry Farm Park, Jacksonville, Alabama [ ] 4.0 Mile XTERRA MONTE SANO STATE PARK TRAIL RUN - 1/12/14 4.0 Mi through Oct 1, $30 Oct 2-Oct 11, $35 (LATE) Monte Sano State Park, Huntsville, Alabama [ ] 9.3 Mile [ ] 3.1 Mile 9.3 Mi through Dec. 31, $30 Jan.1-10, $35 (LATE) 3.1 Mi through Dec. 31, $25 Jan. 1-10, $30 (LATE) *** ALL RACE DAY REGISTRATIONS WILL REQUIRE A $10.00 LATE FEE*** MAKE CHECKS PAYABLE TO: DIRTY SPOKES PRODUCTIONS,LLC TOTAL AMOUNT ENCLOSED $____________ MAIL TO: DIRTY SPOKES - XTERRA - ALABAMA 1911 CARRIAGE BROOK CT. DACULA, GA. 30019 Please check web-site for directions to events: www.dirtyspokes.com ***PACKET PICK-UP 7-8A.M. - RACES START AT 8:30A.M.*** Alabama State Parks Require A $3.00 Parking Fee (Cheaha / Monte Sano / Oak Mtn). Mailed In Registrations Must Be Received 5 Days Prior To Late Registration Date For Each Race. Dirty Spokes will be handing out “Dri-Fit” shirts at each of our trail running races this year! AS WITH ALL RACES – NO GUARANTEE OF A T-SHIRT WITH LATE REGISTRATION. NO REFUNDS: I understand that the entry fee is non-refundable and non-transferable. I also understand the Event(s) will take place rain or shine, at Race Director’s discretion. Race may also be postponed due to natural hazards uncontrollable by Race Director. If race is postponed for any reason, there are no refunds and entry fee will be forwarded to the rescheduled date. WAIVER: In consideration of acceptance of this entry, I waive any and all claims for myself and my heirs against officials and sponsors of the 2013-2014 XTERRA Trail Run Series Alabama for injury or illness which may result directly or indirectly from my participation. I further state that I am in proper condition to participate in this event. I have carefully read and fully understand this agreement. I am aware that this is a release of liability, a promise not to sue, and a contract between myself and the Event(s) parties that will bind my marital community, heirs, personal representatives, assigns, and all members of my family, including any minors, and I sign this agreement of my own free will. Participants Signature (if under 18 – Parent’s Signature) Date .
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