Mississippi 50 Trail Run entry Form

 50 Mile, 50K and 20K Endurance Runs
Saturday March 10, 2007   Laurel, Mississippi

6:00 am start for 50 K and 50M (12 hour time limit), 8:00 am for 20K $65 entry fee till February 15, then $75. No refunds. $10 discount for on-line entry via Active.com
Overall Trophies (3 deep each event Men/Women) ●  Race T-shirt  ● Finisher Memento ● Includes Pasta supper at check-in ($8 for guests, pay at the door) ● Post-race food at finish line
Primitive camping at start/finish ● No pets allowed at start/finish or on course ● Soft dirt trails and fire roads, no paved roads ● Beautiful 12.5 mile and 6.1 mile loops ● Well-supplied aid stations every 3-4 miles with easy crew access ● See www.ms50.com for full details ● A Pine Belt Pacers Gran Prix Event - See www.PineBeltPacers.org
THIS EVENT IS SANCTIONED BY USA TRACK & FIELD  
Sponsored By:
South Central Regional Medical Center

TOUCHSTONE ARCHITECTURE AND CONSULTING, P.A.
TOUCHSTONE DENTAL CARE OF HATTIESBURG    

                                 WAIVER AND RELEASE OF LIABILITY
In consideration of the acceptance of my entry, I, for myself, my executors, heirs, administrator, and assigns do hereby release and discharge any and all sponsors , volunteers and race officials from all claims, damages, demands, causes of action whatsoever in any manner arising out of my participating in the MS50 events.  I affirm that I am physically fit and sufficiently trained to participate in this event, and assume all the risks of such participation.  I understand that there are risks inherent in running long distances on undeveloped land which include but are not limited to, frequent falls, sprains, strains, breaks, dislocations, exposure to the elements, stream and creek crossings which may require swimming, lack of easy access to emergency medical care, and other potentially lethal conditions not in control of the organizers of this event, and that it is not uncommon for death to occur to a participant in an event this physically strenuous.  That understanding and appreciating all of these conditions I assume all the risks of such participation.  I further grant the use of my name and likeness to the event organizers for any use.  Organizers may cancel this event without refunds if, in their judgment, conditions warrant cancellation

Signature: ____________________________________________________________________________________

Name (Print): __________________________________________________________________________________

Address: ______________________________________________________________________________________

City: _____________________________________________________________  State: ______  Zip: __________

Phone: _________________________  E-mail: _______________________________________________________

Age on race day: ________(must be at least 18)   Sex :   M    F     Shirt Size:    S    M    L    XL

Event:   20K    50K    50M     First time at this distance?:  Y   N

Race entry fee $65 if postmarked by 2/15, then $75. ($10 discount - Active.com) Make checks payable to: Carl Touchstone Mississippi Trail 50. Send registration form and check to: 9 Saint Andrews, Hattiesburg, MS 39401