Lake Claiborne Fall O Meet October 17, 2009 - CTRL+P to Print
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Registration Form
Date/Location: October 17, 2009, Lake Claiborne State Park, Homer, LA
Registration: Before 15 Oct. Late: Pre-registration closed. Late registration at the meet site.
First Start: 9:30 a.m. ( Start assigned at registration.) Last Start: 11:00 a.m. Beginners clinic 9:00.
Course: White, Yellow, Orange, Brown, Red & Team. (Team: Orange course. 2 runners per team.)
Categories: M/F, (-14) (15-16) (17-18) (19-34) (35-54) (55+).
Team, Mixed, M and/or F, (-18) and (19+).
Meet Director: Paul Prince, 903-898-2623, PKPrince@eastex.net.
Map/Planner: Colored. Paul Prince
Registration Fees: $8 each. ($6-ALTOS) $10 after 10/14/09.
Concession Stand: Yes (Pay as you go.)
Registration:
Electronic: E-mail, text, or Excel to: jandgman@bellsouth.net. Format as follows: (Name First) (Name Last) (Course) (Gender) (Category) (Group). Bring fees & signed Registration Form to to meet site 10/18/08.
Snail Mail: Gary Hackman, 1112 Old Plain Dealing Road, Benton, LA 71006.
(Pre-registration ends 10/14/09. Late registration fees begin on 10/15/09. Please get your registrations in early.)
Name (Last) ________________(First)________________Gender___Age as of 10/17/09______
Troop/Club/Organization________________Sponsors name/Telephone____________________
Circle One: (White) (Yellow) (Brown) (Orange) (Red) - (Team) Name of 2nd runner___________________
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Hold Harmless Agreement
In consideration for being allowed to participate in the Lake Claiborne Fall Orienteering Meet at the Lake Claiborne State Park, Homer, Louisiana, Oct. 17, 2009, and co-sponsored by the Louisiana Parks & Recreation Department and the Ark-La-Tex Orienteering Society (ALTOS), I hereby agree to assume full responsibility for any and all risks and for my and my children's own safety and do further hereby agree to indemnify, hold harmless, and defend the Louisiana Parks & Recreation Department, ALTOS, and Paul Prince (Meet Director) and all of their officers, employees, and agents, acting officially or otherwise, from any and all liability (whether by negligence, strict liability, or other fault), and from any and all claims, demands, actions, debts, and attorney fees arising out of, claimed on account of, or in any manner predicated on loss or damage to the property of and injuries to, or death of, any persons whatsoever, which may result from my or my children's participation or presence within the limits of the Lake Claiborne State Park in connection with the aforesaid meet or program, and do further hereby waive forever any claims, demands, or actions I or my children may have arising therefrom.
Signature_________________________Date_________________ (Parent signature if under 18)