(Send to organizer) Event: ________________________________ Date : ________

Name: _____________________________ Age: ________
Address: _______________________________________ City: _____________________________ State: ________ Zip: ______________ Phone: (_____) ________________

Do not ride this event without adequate medical insurance.

I, the undersigned, hereby agree, in entering this event, to forever release and discharge the organization promoting this event, and its officers and members, the New England Trail Riders Assoc. Inc., and its officers, directors, and members, all other participants in the event, and all persons over whose property the event may pass, from any and all loss, injury, expense, damage, cause of action, or any claim whatsoever, which I may suffer or sustain, or which may arise out of or in connection with the event and my participation therein. I have read the NETRA Competition Rulebook and fully understand the requirements of event participation therein. I declare that I am competent to enter this event and do so with full knowledge of the dangerous nature of participation and its inherent risk of physical injury.
Signature (minor must have parent sign)

_________________________________
Date:_______
 

Witness/Notary (req'd for minors)

 _________________________________ Date:_______

AMA Number  

Make of
Bike

Engine
CC

NETRA Number

Ability Class (circle appropriate class)
AA   A/Expert   B/Amateur     C/Novice

Hare Scrambles

Enduros

Junior
Enduros

Turkey
Runs

125
200
250
Open

Veteran
Senior
Mini
Junior

Women
4-Stroke
Super Sr.

Women
Bantam
Light
Heavy

Veteran
Senior
Super Sr.
4-Stroke

Junior A
Junior B
Mini A
Mini B
Women

Men
Women
Doubles