Ouachtia Adventure Race Registration

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Race Tracking

Items with an * are required fields. Solos complete Teammate 1 section only.

2010 Ouachita Adventure Race

Team/Solo Name

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

Pre-Race Dinner (Pasta Dinner)

Number attending - Regular Veggie Opt

Post-Race Dinner (BBQ Dinner)

Number attending - Regular Veggie Opt

Special Notes or Instructions

How did you hear about us?

Payment Info

Method of Payment

Check Number

Coupon or Gift Certificate

Number

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.

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

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