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Items with an * are required fields. Solos complete Teammate 1 section only.
2012 Ouachita Adventure Race
Team/Solo Name
Race Format*  
Race Event * 

Teammate 1/Solo
First Name: *
Last Name: *
Gender: *
Male   Female
Birthdate: 
 /   / 
Email:  *
Enter Email Again: *
Day Phone: * ext.
Evening Phone: ext.
Address Line 1: *
Address Line 2:
City: *
State: *
   Outside USA: 
Country: 
Zip: *
T-Shirt Size *
Solo Racer No Yes

Teammate 2
First Name: *
Last Name: *
Gender: * Male Female
Birthdate:  //
Email: *
Day Phone:  ext.
Evening Phone: ext.
Address Line 1: *
Address Line 2:
City: *
State: *
   Outside USA: 
Country: 
Zip: *
T-Shirt Size *
   

Teammate 3
First Name: *
Last Name: *
Gender: * Male Female
Birthdate:  //
Email: *
Day Phone:  ext.
Evening Phone: ext.
Address Line 1: *
Address Line 2:
City: *
State: *
   Outside USA: 
Country: 
Zip: *
T-Shirt Size *  
Support Crew
Support Crew Yes No
Support Crew Leader
* One Support Crew Member is included in dinners with a paid team. Additional meal tickets may be purchased at the event pre-registration.

Misc. Information
Post-Race Dinner (BBQ Dinner)

Number attending -  Regular   Veggie Opt

Post-Race Party (Bar Area, Over 21 ONLY!)

Number attending - Family Area   Adult/Bar

Special Notes or Instructions
 
How did you hear about us?

Payment Info
Method of Payment

 

Check Number or Last 4 digits of Card

 
Coupon or Gift Certificate

Number

Terms and Conditions:  To read the terms and conditions click here.

I have read and agree to all terms and conditions in regards to payments and registrations.    (initials of person issuing payment.) 

You will be directed to a payment page to complete your registration.

Remember that you must complete the payment process to be registered.

**Please print a copy of  the final invoice for your records.

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Ozark Extreme ™, Team Ozark Extreme™, Ozark Extreme Adventure Racing, Ozark Extreme Adventure Sports and Ozark Extreme Adventure Sprints™ and The Ouachita Adventure Race TM are US Trademarks and are the sole property of Ozark Extreme Adventure Sports, LLC. 
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