2003 WIOUWASH QUAD Relay Race Registration

Team Name/Sponsor: _____________________________________________________________________________________

Team Captain: ______________________________________________________________________________________

Leg	Name	Address	City	Zip	Phone/Email	Shirt Size
#1 Run 6-1/2 miles						S      M L     XL
#2 Walk 3-1/4 miles						S      M L     XL
#3 Bike 15 miles						S      M L     XL
#4 Horse 5-1/2 miles						S      M L     XL

WAIVER:    I know that participating in The WIOUWASH QUAD is a potentially hazardous activity.  I understand that I should not participate in the event unless I, and my horse (if I am a horse rider) are medically able and properly trained.  I hereby assume all risks associated with this event and I release, discharge and hold harmless the directors of The WIOUWASH QUAD, its staff, volunteers, all event sponsors and all others in any way connected with the event from any and all claims for injury or damages arising from my participation in it.  I hereby permit The WIOUWASH QUAD the free use of my name and picture in broadcasts, telecasts, newspapers, periodicals and brochures that report or promote this event.

Signature of entrant                 #1__________________________________________   Date: ______________ 

(by parent or guardian            #2__________________________________________   Date: ______________

if under 18)                             #3__________________________________________   Date: ______________

#4__________________________________________   Date: ______________

Registration form may be duplicated.

Send entry and check to:  Town of Clayton Trail Fund, P.O. Box 13, Larsen, WI 54947