2006 Mountain Masochist 50 Mile Trail Race Application
Name: _________________________________________ Age ______ Sex ______
Address:_______________________________________
_______________________________________________ Zip ___________
E-Mail Address ____________________________________________________
Circle the "ONE" you want and please be sure to indicate SIZE.
T-Shirt Size: S M L XL
Sweat Shirt Size: S M L XL
Occupation: ____________________________________________
Phone: Work ( )_________________ Home ( )_________________
Number of Ultras Run _____ Best 50 Miler ___________?
Number of Marathons Run _____ Best Time ___________?
***Number of MMTR Finishes _____ Best Time ___________?
***Please do not forget to include this
Application Fee $70 ($90 after October 14st)
Bus $5
Awards Dinner (per person) $7 ($10 at the door)
Total Enclosed _________
I have been warned that the Mountain Masochist Trail Run is a grueling, grim, and hazardous event and I am fully aware that I could be injured attempting such a run. With this knowledge, I am accepting full responsibility for any harm I might suffer I absolve all sponsors and organizers of the Mountain Masochist Trail Run of any and all liability related to my attempt to run the Mountain Masochist Trail Run.
Signed ____________________________________________________
Date___________________
Mail application to:
David Horton
Liberty University
1971 University Blvd
Lynchburg, VA 24502
