Mail in Entry Form

GEORGIA STATE PARKS TRAIL RUN SERIES REGISTRATION FORM 2018 PRESENTED BY BARBERITOS 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) 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) UNICOI STATE PARK TRAIL RUN – 4/21/18 FORT YARGO STATE PARK TRAIL RUN – 10/13/18 Unicoi State Park, Royston, Georgia Fort Yargo State Park, Winder, Georgia [ ] 7.8Mi [ ] 3.1Mi [ ] 8.75 Mile [ ] 3.1 Mile 7.8Mi through April 8, $30 April 9-19 $35 (LATE) 8.75 Mi through Sept 30, $35 Oct 1-11, $40 (LATE) 3.1Mi through April 8, $25 April 9-19 $30 (LATE) 3.1 Mi through Sept 30, $30 Oct 1-11, $35 (LATE) RED TOP ROASTER TRAIL RUN – 7/28/18 IRON HILL NIGHT TRAIL RUN – 11/3/2018 Red Top Mountain State Park, Cartersville, Georgia Red Top Mountain State Park, Cartersville, Georgia [ ] 9.9 Mile [ ] 3.1 Mile [ ] 7.5 Mile [ ] 3.8 Mile 9.9 Mi through July 15, $35 July 16-July 26, $40 (LATE) 7.5 Mi through October 20, $35 Oct 21-Nov 1, $40 (LATE) 3.1 Mi through July 15, $30 July 16-July 26, $35 (LATE) 3.8 Mi through October 20, $30 Oct 21-Nov 1, $35 (LATE) UNICOI STATE PARK TRAIL RUN – 4/21/18 *** 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 – GEORGIA STATE PARKS TRAIL RUN SERIES 1911 CARRIAGE BROOK CT. DACULA, GA. 30019 Please check web-site for directions to events: www.dirtyspokes.com ***PACKET PICK-UP 6:30-7:30 A.M. – RED TOP MOUNTAIN STATE PARK RACES START AT 8:00A.M.*** ***PACKET PICK-UP 7-8 A.M. – UNICOI AND FORT YARGO STATE PARK RACES START AT 8:30A.M.*** ***PACKET PICK-UP 6-7 P.M. – IRON HILL NIGHT TRAIL RUN RACES START AT 7:30 P.M.*** Georgia State Parks Require A $5.00 Parking Fee. Mailed In Registrations Must Be Received 5 Days Prior To Late Registration Date For Each Race. Dirty Spokes will be handing out “Super Soft Tri Blend” 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 2018 Georgia State Parks Trail Run Series Presented By Dirty Spokes 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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