2013 Arkansas Traveller 100 Application
October 5-6, 6:00 AM
Lake Sylvia Recreation Area, near Perryville, Arkansas
by the Arkansas Ultra Running Association
Presented by the Arkansas Ultra Running Association
Proceeds benefiting the Williams Junction Volunteer Fire Department
Last Name_____________________________ First ___________________ Middle _______
State ____ Zip __________ Phone ____________________
Date of Birth ____/____/_____ Age on 10/5/2013 (Minimum age 18) ______ Gender _______
Previous Ultra Experience?
_______________________________________ Anticipated AT100 finish time: _________
Is this your first 100-mile attempt? _____ Please list any previous years you completed the AT100 __________________
If applicable, please
describe what kind of camping you will be doing at Lake Sylvia (RV, tent, etc.):
List any medical conditions
we should know of _______________________________________________________
Are you taking any
prescription drugs? Please list:
Please provide a contact (name and phone number) in case of an emergency
There will be a free
spaghetti dinner Oct 4th for
the runner and one guest. Please include $5.00 fee for each additional guest.
($179 until July 1; $199 until Sept 1; $219 thereafter; online and mail-in fees are the same
____ X $5.00 =
for additional spaghetti dinners
No entries accepted after September 23 postmark.
Entry limit: 150
Send application and entry fee (check payable to Arkansas Traveller 100) to:
116 Turtle Creek Cove, Maumelle, AR 72113
Cancellation Policy: $165 of entry fee is refundable until July 1st; 2/3 of fee is refundable until September 1; 1/3 until September 23
For additional information, visit the Arkansas Traveller 100 website: http://www.runarkansas.com
phone 501-803- 9411
Race Waiver -
PLEASE READ – This entry contains
limitations of your legal rights.
know that running an ultramarathon race is a potentially hazardous activity that
could cause injury or death. I should not enter and run unless I am medically
able and properly trained, and by my signature, I certify that I am medically
able to perform this event, am in good health, and am properly trained. I agree
to abide by any decision of a race official relative to any aspect of my
participation in this event, including the right of any official to deny or
suspend my participation for any reason whatsoever. I assume all risks
associated with running in this event, including but not limited to: falls,
contact with other participants, the effects of the weather, including high heat
and/or humidity, traffic and the conditions of the road and trail, encounters
with wild or domestic animals, all such risks being known and appreciated by me.
Having read this waiver and knowing these facts and in consideration of your
accepting my entry, I, for myself and anyone entitled to act on my behalf, waive
and release the race directors and workers, Arkansas Ultra Running Association,
U.S. Forest Service, and all sponsors, their representatives and successors from
all claims or liabilities of any kind arising out of my participation in this
event, event though that liability may arise out of negligence or carelessness
on the part of the persons named in this waiver. I grant permission to race
management to use any photographs, recordings, or other records of my
participation in this event for any legitimate purpose.
I also understand that the race director has the right to refuse any
entry, and that my registration fee is non-refundable after September 23, 2013.
Signature ______________________________________ Date ____________