First Name Last Name Male Female Age
Address City State Zip
Telephone E-mail
Emergency Contact (required) Phone
T-Shirt Size (adult sizes only, entries received after 06/14/09 not guaranteed a t-shirt) S M L XL
I hereby release all sponsors of this event from any and all claims of liability that may arise from my participation in this competition. I agree to allow Beartooth Run/Burn/Events Officials, Race Organizers and Media representatives the use of my name, photos, video tapes, comments or commentaries to help publicize and promote Beartooth Run/Burn/Events.
Age Category
12 & Under 13-15 16-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60+
Entry Fee: Pre-Registration (on or before June 14, 2009) Age 15 and under ............................................$25 Age 16 and over ..............................................$30 Registration (after June 14, 2009) Age 15 and under ............................................$30 Age 16 and over ..............................................$35 Pasta Dinner Meals at $13 Each Kids Pasta Dinner Meals at $7 Each
Entry Fee:
Pre-Registration (on or before June 14, 2009)
Age 15 and under ............................................$25
Age 16 and over ..............................................$30
Registration (after June 14, 2009)
Age 15 and under ............................................$30
Age 16 and over ..............................................$35
Pasta Dinner Meals at $13 Each
Kids Pasta Dinner Meals at $7 Each
Total Charge $ * Numbers Only - No other Characters! ex: 33 NOT $33
