28th Annual
PRE-BIRKIE REGISTRATION FORM
10:00 A.M. Saturday, February 13, 2010

$50.00 by December 15, 2009, $60.00 by January 15, 2010 or $70.00 to the Race Date.

Please print out the form below and then fill out completely and send along with your registration fee to:

Hayward Lions Club Pre-Birkie
P.O. Box 306
Hayward, WI 54843

Last Name:


Please Select Race:
26 Km XC SKi Race

First Name:
Birth Date:      Sex:     M F
Address:  
City:  
State:    ZIP:    
Country:  
Phone Number:  
T-Shirt Size:                 S M L XL  
I hereby release the sponsoring club, its members or agents and any persons officially connected with this competition from all liability for any injury or damages.
   
Signature:

Signature of Parent Required if Participant is Under 18 Years of Age.

 

Hayward Lions Club Pre-Birkie
P.O. Box 306
Hayward, WI 54843
Phone: (715) 634-6456
prebirkie@cheqnet.net
© Copyright 2000 Hayward Lions Pre-Birkie.
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