New England Nordic Ski Association Race Entry Form
Flying Moose Classic

February 15, 2008

Bethel Outing Club, Bethel, Maine

Name: ___________________________________                           NENSA # _______________           

Address: _________________________________ Phone#__________________                                      

Town ____________________________________State_____ Zip:___________Age D.O.R.                    

Club _____________________Email                                      ________Date of Birth _________                 

Class:  (circle one)                 Sex: (circle one)   Male        Female

Junior:  0-19

Senior:  20-30

Master1:  36-49

Master2:  50+

Event: (circle one)

20 km race                   20 km tour

10 km race                   10 km tour

                                      6 km tour  

Registration Fee:  (circle one amt.)  20km & 10km race & tour = $25  ($15 BOC members)

   6 km tour =                             $5 
             

(Office use:  Bib #___________)
           

Waiver:
In consideration for the rights and privileges associated with participation in a New England Nordic Ski Association event, I acknowledge and agree to be bound by the following:

1. Identification of Risks. I understand that participation in any skiing activity, including but not limited to, preparation for, participation in, and coaching of activities in cross country ski competitions and clinics, involve risk of serious injury, including permanent disability, death and other losses, due to inactions or negligence of myself or others.
2. Assumption of the Risk. I agree that I am responsible for my safety while participating in activities associated with NENSA, and that such responsibility includes participation 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. I assume all risk connected with responsibility for any injury or loss connected with my participation.
3. Waiver. Aware of the risks and willing to assume them, I hereby waive, release and agree to hold harmless the Bethel Outing Club, the New England Nordic Ski Association, its affiliates, subsidiaries, officers, directors, employees, agents, coaches, trainers, doctors, officials, event organizers or sponsors (Released Parties) from any and all claims by me for any liability, injury, loss or damage in any way connected with my participation in activities associated with NENSA, except where caused by the gross negligence or willful or wanton misconduct of any of the Released Parties. I intend for this waiver and release to also apply to any relatives, personal representatives, heirs, beneficiaries, next of kin or assigns who may pursue any legal action or claim on my behalf.
4. Insurance. I currently have, and agree to maintain throughout the time that I train and compete, 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.

Signature__________________________________Date ___________________
    Parent or guardian signature and printed name if participant is under 18 years of age.

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