The 2012 Shenandoah Mountain 100 Backcountry Race
Harrisonburg, VA | Sept. 2nd, 2012
Deposit for R E G I S T R A T I ON

Please print, fill-out, and send this registration along with a non refundable
check made out to:
Shenandoah Mountain Touring, L.L.C.

We are accepting deposits (paid in full) on registration until our permit with the USFS is finalized. These deposits are refundable until our permit is approved. We will notify you when the permit is approved at which time you will be able to request a refund if you wish. When we have the permit we will open up registration on Active.com - For now please print and
mail this form with a check.

Early Registration is $150.00 must be postmarked before March 3rd, 2012
Regular registration is $170 until April 14th, 2012
Late Registration is $190 - ONLINE ONLY - June 2nd, 2012
Last minute registration after 9:00 PM June 2nd $210 online only

No Refunds
Transfer to another person $20 - 30 days prior to event only
Transfer to another person $50 - within 30 days of the race
We do not carryover entries to another year
We are not responsible for missing drop bags

Mail to:

Shenandoah Mountain Touring, L.L.C.
P.O. Box 1423
Harrisonburg, VA 22803

Name:_____________________________________________

Age: ________ Sex:_______ Email:__________________________

Street: _________________________________________________

City: ___________________________________ State: __________

Zip: __________________ Shirt Size:_________________________

Phone: Cell# ___________________ Home #_________________

Emerg #_________________ Master 50+? ___ Clydesdale 200lb+ ___

Main Sponsor ___________________________ Singlespeed ? _______8-26-11