Frederic Lions Classic               

28 Mile Time Trial

www.fredericlionsclassic.com

June 14, 2008

--28 mile time trial  (This is a WiSport qualifier but you don’t have to be Wisport member to race)

--Camping the night before and showers after race available

--Start–Frederic, WI  High School parking lot at 10:00am

--Website has details or contact Roxanne at 715-327-4892 or sbtesch@centurytel.net

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First Name______________________­­­­­___________        Last Name___­­­­­­­­­­­­­___________________________________

Address___________________________________        City, State & Zip_______________________________________

Phone #___________________________________        E-mail Address________________________________________

Age (as if July 1st, 2008)______________________       Gender:   ________   Male            _________  Female

 

28 mile time trial

Category: Single (postmarked on or before 5/26/06)       ______  $25.00

Tandem (anytime – one fee but two forms)         ______  $40.00

 

Are you a WiSport Bike Series member?                                   ______  Yes                              ______ No

(This is a  WiSport qualifier but you don’t have to be a Wisport member to be in it)

 

Make Checks Payable to:                      Frederic Lions Club (or FLC)

Return to:                                              Frederic Lions Classic , P.O. Box 411, Frederic, WI 54837

 

By entering and racing in the Frederic Lions Classic I hereby waive and dismiss all claims for damage and personal injury I may incur before, during,

or after the event.  I hereby release the Frederic Lions Club, the Village of Frederic, their members and representatives, all sponsors, medical personnel,

race officials, volunteers, and village residents from any liability.

 

_____________________________________________              ______________________________________________

Signature                                                          Date              Parent or Guardian (must attend event)                Date

 

Committee Use Only:  28 Mile  Time Trial          Single or  Tandem

Date Received: _________ Amount Paid:  __________           Check #: _____________

Race Number: __________            Update Address __________            New____________