Running with the Bears

First Name
Last Name
Address
City,State Zip	,

Phone Number
Emergency Contact	Phone:
E-Mail Address

Gender	Male Female
Birth Date	(mm/dd/yyyy)

Desired Race

	RELEASE STATEMENT: I hereby release all sponsors and organizers of Mountain Circle Marathon as well as all units of government and private land holders whose jurisdiction this event shall pass through, all agents and officers of the above and all parties associated with this event, for the responsibility for injury to myself and my equipment sustained during the course of this event. I also agree to abide by the rules established for the Mountain Circle Marathon and those established for traffic laws of California.
	Check the box to signify that you agree

Running with bears