Registration

REGISTRATION FORM

First Name:

Middle Initial:

Last Name:

Sex:

M
F

Age:

*
(as of 12/31/08)

Date of Birth:

Address:

Address 2:

City:

State/Province:

Nation:

ZIP/Postal Code:

Day Phone:

Evening Phone:

E-mail Address:

Select Event:

58K Freestyle
42K Classic
35K Freestyle
13K Freestyle
58K Relay

I plan to ski the City of Lakes Loppet and Mora Vasaloppet to earn the Doubleloppet Award

Fee Schedule:

58K, 42K Classic, 35K		13K Race:	Adults	Under 18 yrs as of 12/31/08
Through 9/01/08	$65.00	Through 12/31/08	$45.00	$25.00
9/02/08 - 10/31/08	$75.00	1/01/09 - 1/31/09	$55.00	$35.00
11/01/08 - 12/31/08	$85.00	2/01/09 - 2/06/09	$60.00	$40.00
1/01/09 - 1/31/09	$95.00	Saturday 2/7/09	$65.00	$45.00
2/01/09 - 2/06/09	$105.00
Saturday 2/7/09	$110.00
2/08/09 - Sunday - No race day registration.

58K Relay
Through 12/31/08	$200.00
1/01/09 - 1/31/09	$210.00
2/01/09 - 2/06/09	$215.00
Saturday 2/7/09	$225.00
2/08/09 - Sunday - No race day registration.

Card Type:

Card Number:

Card CVV:

Expiration Date:

Registration Charges:

Waiver:

1. Identification of Risks. I understand that participation in any skiing activity, including but not limited to preparation for, participation in, coaching and related activities in nordic and freestyle, competitions (“the Activity”), involves risks of serious injury, including permanent disability, death and other losses, both to me and my property. I understand that these injuries and losses might result not only from my actions, but the actions, inactions or negligence of others.

2. Assumption of the Risk. I agree that I am responsible for my safety while participating in the Activity and that such responsibility includes participating in the Activity only: a) when I am both physically and psychologically prepared to participate safely, b) after fully familiarizing myself with the venue before beginning the Activity, and c) while using the equipment of a type and condition reasonably necessary to safely participate in the Activity, I assume all risks connected with responsibility for any injury or loss connected with my participation in the Activity.

3. Waiver. Aware of the risks and willing to assume them, I hereby waive, release and hold harmless Mora Vasaloppet, Inc., officers, directors, employees, agents, event organizers or sponsors (“Release Parties”) from all claims by me for any liability, injury, loss or damage in any way connected with my participation in the Activity. I intend for this waiver and release to also apply to any relatives, personal representatives, heirs, beneficiaries, next of kin or assigns who might pursue any legal action or claim on my behalf.

4. Applicable Law. This waiver and release informed under and is to be interpreted consistent with laws of the state of Minnesota.

5. Insurance. I currently have, and agree to maintain throughout the time that I participate, valid and sufficient medical and accident insurance. I understand that this is my sole responsibility and release all persons and entities from providing this coverage for me.

FOR ATHLETES OF MINORITY AGE

(If athlete is less than 21 years of age and a resident of West Virginia, Alabama, Mississippi, Nebraska, Pennsylvania or Wyoming, or less than 18 years of age and a resident of any other state, then the parent or legal guardian must check below.)

This is to certify that, as parent/guardian of this participant, I do consent to his/her agreement to be bound by each of the terms and conditions identified above.

I have read and agree to the paragraph above.