TourdeKale Ride and 5k road race and walk  - Cost and registration form.  Print info below Here......  

5k night road race and bike ride -  $45.00

120k - extreme summit challenge -$35.00

110k rolling to hilly challenge -      $35.00

60k - moderate to rolling -           $35.00

25k - moderate ----------------  $35.00              

[ lunch included ] registration is $40.00 day of ride.

5k night road race - $20.00 ~ 1 mile fun run - $20.00 ~ Walk - $20.00 - please add $5.00 if you want lunch on saturday

Please add a $10.00 deposit for electonic ankle band. $10.00 will be Refunded at the end of the event. Will be using OFF N Running scoring to monitor events. No aero bars allowed.

Windsong Bicycle Shop in Salisbury will be providing tech service for the TDK

 **************************************************************************

PARTICIPANT INFORMATION (Please Print)

(circle one)  SELECT COURSE: 120 SUMMIT CHALLENGE 110K 60K 25K 5K NIGHT RUN 1 MILE FUN RUN-WALK

FIRST/LAST NAME:___________________SEX: MALE FEMALE AGE (DAYOF EVENT):________

ADDRESS: ________________________   EMAIL:_____________________________________

CITY-STATE-ZIP________________________SELECT SHIRT SIZE:   S  M  L  XXL

HOME PHONE:_____________________  FUNDRAISING GOAL:________________

EMERGENCY CONTACT.EMERGENCYPHONE:________________________________

Bubba Division 200 + lb male competing in the 120k Summit Challenge  (circle)  Yes  No

PLEASE ENCLOSE A CHECK OR MONEY ORDER IN THE CORRECT AMOUNT WITH YOUR REGISTRATION FORM. (MAKE

CHECKS PAYABLETO CANAAN UNITED METHODIST CHURCH TDK FUND) I ACKNOWLEDGE THAT MY REGISTRATION FEE

AND ANY DONATIONS THAT I MAY RAISE WILL NOT BE REFUNDED IF I CHOOSE NOT TO PARTICIPATE IN THE EVENT.

PLEASE SIGN THE WAIVER

LIABILITY RELEASE AND WAIVER

For and in consideration of the right to participate in the Tour de Kale event, the undersigned

does hereby release, absolve and hold harmless Canaan United Methodist Church, their sponsors,

heirs, successors, assigns, volunteers, agents, and personnel from any and all actions,

cause of action, liability or responsibility what so ever, or any injury, harm, loss or inconvenience

suffered or incurred by the undersigned during or as a result of taking part in the Tour de

Kale. The undersigned further understands that obedience of traffic regulations and signal.

devices is his or her own responsibility. The undersigned understands and agrees that the

sponsors make warranties what so ever and are not responsible for one's safety during the

Tour de Kale.,or while traveling to and from the Tour de Kale.

I, the undersigned, have fully read, understand and agree to all terms contained herein and so

signify by signing and dating below.

Signed _____________________________________Date___________________

If applicant is under 18 years of age, a parent or guardian must read and agree to the above conditions

and is consenting to entrants participation. If agreeable, he or she must sign and date above.

Mail to:    TDK c/o Sheri Skeen

           726 Mountain Shore Drive