|
Step 1 of 2 - Runner Registration |
First Name | Last Name
|
Address 1
| Address 2
|
City
|
State / Province
Use 2 digit code for US and Canada otherwise, leave blank. | Country, if outside of the U.S. and Canada
Leave blank if address is in US or Canada. |
Zip / Postal Code
| |
Primary Phone Number
Required... please provide your primary number. | Other Phone
Optional... provide an alternate phone number. |
Email Address
Your active Email Address... please check for accuracy. |
Runner's Date of Birth
Format: YYYY-MM-DD | Sex
M for Male, F for Female. |
|
| | | | Apparel Description We're pleased to offer the choice of a long or short sleeve moisture wicking tech shirt to pre-registered participants. We will strive to get X-small sizes, but if not available will substitute a small. Shirts will come in women's cut when applicable. | | | | |
|
Shirt Selection
|
|
Emergency Contact Name
| Emergency Contact Phone Number
|
Required... provide the name and phone number of someone who is not running in the race as a contact, which we may use in the unlikely event of an emergency. |
|
What is your Predicted Finish Time?
| Your Preferred Start Time?
|
Required... please help with our planning by (a) predicting your finish time for a trail run of your selected event distance, and (b) indicating your preferred starting time within the race-start window of 6:00 pm to 8:00 pm on Saturday evening. |
Are You an active Member of the Ice Age Trail Alliance?
Members only... select Yes above if you're an active member of the Ice Age Trail Alliance (otherwise, leave blank). Active members will qualify for a registration discount. Note: Membership will be verified. |
Charitable Donation to Ice Age Trail Alliance
Optional... please consider an additional charitable donation. We're pleased to donate a portion from each registration to the Ice Age Trail Alliance, whose mission is "to create, support and protect the Ice Age National Scenic Trail." Your additional charitable donation will go directly to this worthy cause, with which we maintain a close partnership. Contributions will be matched dollar-for-dollar, up to $5,000, by Kettle 100 Endurance Runs! |
Charitable Donation to Build a Shelter at Scuppernong in Memory of Tom Bunk
Optional... please consider an additional charitable donation to the shelter that is planned near the Scuppernong Trailhead in the Southern Kettle Moraine Forest in memory of Tom Bunk. Tom was a lifetime friend and champion Kettle 100 Mile runner, volunteer, trail-marker, and local ultra legend. Contributions will be matched dollar-for-dollar, up to $5,000, by Kettle 100 Endurance Runs! |
Waiver
I know that running a trail race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I agree to abide by any decision of race officials relative to my ability to safely complete the run. I assume all risks associated with running in this event including, but not limited to: falls, contact with other participants, becoming lost, injuries or illness from animals or plants, the effects of weather and all risks associated with event participation. Having read this waiver and knowing these facts and in consideration of you accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the State of Wisconsin, Ice Age Trail Alliance and all race officials and agents, all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. Athletes who do not follow course rules, general good sportsmanship or race day guidelines put forth by the race director’s will face potential disqualification and loss of eligibility for future events. The race directors and their contracted partners, including Focal Flame Photography (official race photographers), reserve the right to use photos taken during the event for webcast, current and future promotion online and in social media. Agree to waiver by checking here.By agreeing to this waiver you submit to the terms and conditions as set forth by this event and certify that you have provided true and accurate information as requested through this registration process. |
|