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Rim Nordic Mt. Bike Racing 2009 Registration Form This form can not be submitted through email. Please fill out registration form, print and fax or mail form to Rim Nordic Ski Area Office Use Only Catg.______Bib #______ Total Paid $___________ Date Rcv'd___________ Check/Visa/Cash Int.____
USA #: Rim Nordic Racing Card #. RACING AGE (Age as of 12/31/09): DATE OF BIRTH: (mm/dd/yy): MALE FEMALE Email address:
LAST NAME: FIRST NAME: M.I.: ADDRESS: APT #: CITY: STATE: ZIP: HOME TELEPHONE: DATE OF RACE: Category/Class Entered - Please X the category you race in and enter the corresponding letter or # here: Sponsor/Team Name:

Rim Nordic Mt. Bike Racing 2009 Registration Form

This form can not be submitted through email.
Please fill out registration form, print and fax or mail form to Rim Nordic Ski Area

Office Use Only
Catg.______Bib #______
Total Paid $___________
Date Rcv'd___________
Check/Visa/Cash Int.____

USA #:

Rim Nordic Racing Card #.

RACING AGE (Age as of 12/31/09):

DATE OF BIRTH: (mm/dd/yy):

MALE FEMALE

Email address:

LAST NAME: FIRST NAME: M.I.:
ADDRESS: APT #:
CITY: STATE: ZIP:

HOME TELEPHONE:

DATE OF RACE:

Category/Class Entered - Please X the category you race in and enter the corresponding letter or # here:

Sponsor/Team Name:

FAX ENTRIES PAID BY CREDIT CARD ONLY

visa master

PRO & CAT 1

CAT 2

CAT 3

Pro Men
Pro Singlespeed
Pro Women
(A) Jr. Men 12-18
(B) Men 19-24
(C) Men 25-29
(D) Men 30-34
(E) Men 35-39
(F) Men 40-44
(G) Men 45-49

(H) Men 50 -54

(I) Men 55 +

(JJ) Jr. Wm 12-18
(KK) Women 19-29
(LL) Women 30-39
(MM) Women 40+
CAT 1 Single Speed

(J) Jr. Men 18 & under
(K) Men 19-24
(L) Men 25-29
(M) Men 30-34
(N) Men 35-39
(O) Men 40-44
(P) Men 45-49
(Q) Men 50-54
(R) Men 55-59

(S) 60+

(AA) Sp. Jr. Wm 18 & under
(HH) Women 19-29
(RR) Women 30-34
(TT) Women 35-39

(VV) Women 40-49
(XX ) Women 50+
(WW) Clydesdale
(SS) Single Speed

NO REFUNDS

(aa) Women 14 & Under (1 lap)
(BB) Women 15-18 (1 lap)
(CC) Men 10 & under (1 lap)
(DD) Men 12 & under (1 lap)
(EE) Men 14 & under (1 lap)
(FF) Men 16 & under
(GG) Men 18 & under
(T) Men 19-24
(U) Men 25-29
(V) Men 30-34
(X) Vet Men 35-39
(Y) Vet Men 40-44
(Z) Men 45-49
(YY) Men 50-54
(ZZ) Men 55 +
(NN) Women 19-29
(OO) Women 30-34
(PP) Women 35-39
(QQ) Women 40+
(W) Clydesdale 200lb+
Tandem (1-2 laps)

FEES
Registration ($35 ....jr. $25) VIP Card ($25) Season Race Pass (4 Race Series) ($120) Season Pass with Stage Race ($160) T-Shirt (100% cotton) $10.00 Size - S M L XL	$ $ $ $ $
No USA Cycling License Fee - $5.00 (Per Race)	$
Mail Race Results - $1.00	$
TOTAL	$

Payment Method
Check or Money Order Visa Mastercard Name on Card Card Number - - - Bank Card Expires Signature____________________________________________________
MAIL or FAX to: RIM NORDIC, Box 2990, Running Springs, CA 92382 Phone: (909) 867-2600, Fax: (909) 867-4128

In consideration of this entry, I hereby for myself, my executors, administrators and assignees waive any and all right of claims for damages I may have against Rim Nordic Ski Area, Inc., all sponsors and individuals associated with said event for any and all injuries sustained by me in this event. Also, none of the above are responsible for the loss of personal items not any other form of aggravation in connection with the said event. I attest and verify that I am physically fit and have trained for this event. In signing this form, I acknowledge I have read and full understand my own liability and do accept the restrictions.

Rim Nordic Mt. Bike Racing 2009 Registration Form

This form can not be submitted through email.
Please fill out registration form, print and fax or mail form to Rim Nordic Ski Area

USA #:

Rim Nordic Racing Card #.

RACING AGE (Age as of 12/31/09):

DATE OF BIRTH: (mm/dd/yy):

MALE FEMALE

Email address:

LAST NAME: FIRST NAME: M.I.:
ADDRESS: APT #:
CITY: STATE: ZIP:

HOME TELEPHONE:

DATE OF RACE:

Category/Class Entered - Please X the category you race in and enter the corresponding letter or # here:

Sponsor/Team Name:

FEES

Payment Method

Check or Money Order Visa Mastercard

Name on Card

Card Number - - -

Bank Card Expires

Signature____________________________________________________

MAIL or FAX to:
RIM NORDIC, Box 2990, Running Springs, CA 92382
Phone: (909) 867-2600, Fax: (909) 867-4128

Signature (If minor, Parent must sign)__________________________________________

Date Signed_______________________

Rim Nordic Mt. Bike Racing 2009 Registration Form

This form can not be submitted through email. Please fill out registration form, print and fax or mail form to Rim Nordic Ski Area

USA #:

Rim Nordic Racing Card #.

RACING AGE (Age as of 12/31/09):

DATE OF BIRTH: (mm/dd/yy):

MALE FEMALE

Email address:

LAST NAME: FIRST NAME: M.I.: ADDRESS: APT #: CITY: STATE: ZIP:

HOME TELEPHONE:

DATE OF RACE:

Category/Class Entered - Please X the category you race in and enter the corresponding letter or # here:

Sponsor/Team Name:

FEES

Payment Method

Check or Money Order Visa Mastercard

Name on Card

Card Number - - -

Bank Card Expires Signature____________________________________________________

MAIL or FAX to: RIM NORDIC, Box 2990, Running Springs, CA 92382 Phone: (909) 867-2600, Fax: (909) 867-4128

Signature (If minor, Parent must sign)__________________________________________

Date Signed_______________________

This form can not be submitted through email.
Please fill out registration form, print and fax or mail form to Rim Nordic Ski Area

LAST NAME: FIRST NAME: M.I.:
ADDRESS: APT #:
CITY: STATE: ZIP:

Bank Card Expires

Signature____________________________________________________

MAIL or FAX to:
RIM NORDIC, Box 2990, Running Springs, CA 92382
Phone: (909) 867-2600, Fax: (909) 867-4128