29th ANNUAL GREAT LABRADOR
LOPPET
Sponsored By Provincial Airlines
Co-Sponsor Iron Ore Company of Canada
C/O Menihek Nordic Ski Club
P.O. Box 38, Labrador City, Newfoundland, Canada A2V 2K3
Phone: 709-944-5842 Fax: 709-944-5975
| Family Name: | |||||
| First Name | Age | Birth Date (D/M/Y) | Sex | Event (circle one) | Bib # |
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M F |
10k 27k
54k
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Office |
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M F |
10k 27k
54k
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M F |
10k 27k
54k
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Use |
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M F |
10k 27k
54k
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M F |
10k 27k
54k
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Only |
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Note: Please do not register
child as a participant if being towed in a Baby Polk. The
cost of renting poles is $10.
If you need a polk please call 944-5842 and leave message to book before the
race.
Team or Club Name: _____________________________________________
Home Address: _________________________________________________
City: _______________________________ Province:__________________
Postal Code: _________________________ Phone:(___)_________________
FEES - PAYMENT MUST ACCOMPANY ENTRY FORM - Cash,Cheque, Money Order or Visa (payable to Menihek Nordic Ski Club)
| SINGLE RATES |
FAMILY RATES |
Late Registration | Total Fees Paid | ||
| Club Member | $15.00 | Club Members | $30.00 | N/A | $ |
| Non-Member | $25.00 | Non-Members | $45.00 | N/A | $ |
| Junior (13 to 18yrs) | $10.00 | N/A | N/A | N/A | $ |
| Junior(12 and under) | $ 5.00 | N/A | N/A | N/A | $ |
Registration fees include: Bus to Fermont, refreshments at rest areas , pasta supper (Friday night), Bib #, and prizes and medals.
Note: Registration deadline is Friday March 26th, 2004 at 9pm
Participants may order T-Bone dinners for $25.00 each, to be served at the awards banquet following the loppet . The Banquet will commence at 7:00 pm and will be held at Smokey Mountain Ski Lodge. Please indicate the number of dinners required below. Payment must be made in advance, on or before Friday, March 26th, 2004.
NOTE: There will be NO admittance to the banquet and dinner without a ticket.
| DINNERS ___________ | TOTAL = $ | IS PAYMENT ENCLOSED? Y / N |
PLEASE READ AND SIGN THE FOLLOWING:
All participants under 19 must have their parent or legal guardian sign this release: I consent to my child's (children's) participation in the Great Labrador Loppet and hereby release liability for injury or damage sustainedby my child (children) through participation in the Great Labrador Loppet and hereby release all sponsors and organizers of this event from all liability for injury or damage sustained by my child (children) through participation in this event.
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SIGNATURE & DATE
All participants who are 19 or over must sign this release: I hereby release all sponsors and organizers of the Great Labrador Loppet from anyliability for injury or damages sustained by me through participation in this event.
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