UNCLE JOE 50KM ULTRAMARATHON
SATURDAY, SEPTEMBER 12, 2009
9:00 am START
No Name Lake near Bead Lake, WA

Entry Fee: Entry fee $70 (US funds) by August 12, 2009--$85 (US funds) after August 12, 2009. 

DAY OF RACE REGISTRATION $100.
NO REFUNDS AFTER August 25, 2009.
No Early Starters.   
 
Name (Please Print):___________________________________Age on Race Day:________
 
         Sex:  M    F (circle one)             Shirt Size: S  M  L  XL (circle one)      

      Address:____________________________/_____________________/___________/__________ 
                                Street                               City                           State               Zip

Email:___________________________________Phone (Day/Evening:(______)_________

My longest run in training:__________miles.  My longest race: ___________miles.                                       

Waiver:  I know that participating in the Uncle Joe 50 Km Ultramarathon is a potential hazardous activity.  I
understand that the course is difficult with a rugged trail and mountain roads.  I understand that running on
the trail and mountain roads may subject me to injury and/or illness, or worse.  I understand that I may have
wildlife encounters, rapid weather changes, falling trees, roots, rocks or other hazards.  I should not enter
and participate unless I am medically able and properly trained. In signing, I give statement that I am in good
health, that I have trained sufficiently to participate in this event, will be prepared for race day conditions, and
there is no medical reason that I should NOT attempt this feat.  In consideration of acceptance of this application
by the race sponsors, I forever waive, release, and discharge any and all rights, demands, claims for damages,
and causes of suit or action that I may have against any and all race organizers, sponsors, supporters,
volunteers, private land owners, Pend Oreille County, the U.S. Forest Service, the Joseph Heslin Foundation
and the Road Runners Club of America.  I will assume and pay my own medical and emergency expenses in
the event of accident, illness, or other incapacitation, regardless of whether I have authorized such expense. 
The forgoing release is binding upon me personally, as well as upon my heirs, executors, administrators, all
members of my family, or any others who might make a claim on my behalf.

Signature:_______________________________________________Date:_________________

I certify that I am a fine person, who likes to reduce my taxes and who wants to help provide
college scholarships to deserving young people.  With the faith of an ultrarunner that the
running gods will relax my calves, loosen my hamstrings, increase the stroke volume of my
heart, and cause a strong wind to blow at my back in the latter stages of the Uncle Joe 50Km
because of my generosity, I hereby enclose an additional TAX DEDUCTIBLE  donation
of $_____________ to the Joseph Heslin Foundation.