6th Annual Tour the Montour Trail Ride
Sept. 20, 2008


Benefit of the Montour Trail

ENTRY FEES
  Adults
Adult
Postmarked by September 12 $20
Postmarked after September 13 $25
Family Rate **
Postmarked by September 12 $35
Postmarked after September 13 $40
Children Under 12
Postmarked by September 12 $5
Postmarked after September 13 $5
 

**The Family Rate applies to the 6 and 12-mile courses only. Limit of 4 family members per family rate. Children under 12 pay $5 when accompanied by a parent or guardian.

Make checks payable to:

Montour Trail Council
(Please do not sent cash.)


Mail to:
Tour the Montour
PO Box 459
Imperial, PA 15126
Please print
Name:
Address:
 
City:                                State:      Zip:
Phone:
Email:
Male/Female:               Age:           
Additional Names:

Name:                                  M/F:        Age:       

Name:                                  M/F:        Age:       

Name:                                  M/F:        Age:       

Name:                                  M/F:        Age:       

Name:                                  M/F:        Age:  
Distance: 6   12   24 44
T-Shirt Size:
 S     M     L     XL  XXL 
Waiver: : in consideration for the acceptance of this entry, I waive for myself, my heirs and assigns, all rights and claims for damages which I might have against the Montour Trail Ride, to be held on Saturday, September 20, 2008; the Montour Trail Council, other sponsoring organizations, business, or individuals as a result of any and all injuries suffered by myself in that event. I also release any photos that may involve myself. (Must be signed by guardian if under the age of 18)
Signature:
If under 18, parent or guardian must sign below:
                                                                             
Signature of parent or guardian