TOUR de CREST Entry Form
Friday, June 22, 2012

New Event - Part of the Pacific Crest Weekend Sports Fesitival Experience

TWO TOURS: 25-Mile & 55-Mile

Web site: www.racecenter.com/pacificcrest
Email: events@racecenter.com

Instructions
> Type in your information in the blanks provided.
> Print entry form & SIGN WAIVER (Entry will not be accepted without the signed waiver)
> Make Checks Payable
to: Tour de Crest

Mail to:
AA Sports, Ltd. c/o Pacific Crest
4836 SW Western Ave
Beaverton, OR 97005

EVENT (Choose One)

INDIVIDUAL
(Tour Fee includes Pacific Crest Commmemorative Tech shirt, finisher medal, a weekend of entertainment and fun.

First Name / MI / Last Name

Street Address

City

State/Province

Zip/Postal Code

Birthdate - mm/dd/yy

Age

Gender

Phone

Email


T-Shirt Size (included with entry fee)



Check#

Amount Enclosed


WAIVER MUST BE READ, SIGNED AND MAILED WITH ENTRY
OFFICIAL WAIVER: I acknowledge that a Multi-Sport Event is an extreme test of a person's physical and mental limits and carries with it the potential for death, series injury, and property loss. I HEREBY ASSUME THE RISKS OF PARTICIPATING IN THIS EVENT. I certify that I am capable of completing all disciplines of the event, and that I am physically fit and that I have sufficiently trained. I agree to abide by the competitive rules. I hereby take the following action for myself, my executors, administrators, heirs, next to kin, successors and assigns, or anyone else who might claim or sue on my behalf, and I hereby waive, release and discharge from any and all claims, losses, or liabilities for death, personal injury, partial or permanent disability, property damage, medical or hospital bills, or theft which may arise out of or relate to my participation in this event. I agree not to sue, and to hold harmless any and all persons, sponsors, volunteers, participants or government agencies for any and all claims or liabilities that I have waived, released or discharges herein.I understand that my email / contact information might be used for future promotional purposes. ENTRY FEES ARE NON-REFUNDABLE.

Type Full Name


Signature X ___________________________________________________________________
(Signature of Parent or Legal Guardian if participant is under the age of 18)

Date________________________________________