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ADVENTURE RACE
APPLICATION
Payment by credit card:
CLICK HERE
Payment by check or
money order: Print application below, mail in with payment.
Please mail to: Ultimate Sports Association, PO Box 330
Killington, VT 05751
Please Print
First Name
_________________________________
Last
Name
_________________________________
Gender: Female or
Male Date of Birth: ____________________( must
be 18 yrs old to enter)
Telephone: _______________________ Email
Address: _______________________________________
Mailing Address
_______________________________________________________________________
City
__________________________________________________ State/ Zip
Code: _________________
Shirt Size: M L XL
Emergency Contact:
______________________________ Telephone:
_________________________
Team
Name:
________________________________________________________________________
Team
Members:
__________________________________________________________________________Shirt
Size: M L XL
__________________________________________________________________________Shirt
Size: M L XL
__________________________________________________________________________Shirt
Size: M L XL
Does your team have a support person? YES
or NO (circle one)
Name:
____________________________________________________________________Shirt
Size: M L XL
Race
Entering:
( Discounts applicable for entering more than 1 race)
___Ultimate Adirondacks Adventure Race
___Ultimate Green Mountain Adventure Race
Division
Entering:
___Championship
(Team of 4 co-ed)
___Open - Co-ed
___Open - All female
___Open - All Male
___Duo (Team of 2 any mix)
Series Cost:
Only 1 Race in the
Series
Champion Division (Team of 4):
$425
Open Divisions (Team of 3):
$375
Duo Divisions: $250
Discount:
Register for Multiple Races to receive these discounts
:
Both races in the Series
Champion Division (Team of 4): $800
Open
Divisions (Team of 3):
$700
Duo Divisions (Team of 2):
$475
Unsupported Option:
Either race in the
Series:
$50
each
ALL PARTICIPANTS
MUST SIGN RELEASE FORM AND ATTEND PRE-RACE MEETING
Net Proceeds from all races of the Ultimate Adventure Race
Series will benefit
Ultimate Sports Association Inc. USA Inc.
Not for profit 501-c3 corporations dedicated to providing
support to young
athletes
and volunteer coaches.
Contributions will be gladly
accepted:
Click Here
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