Name of E vent: .

E vent Date .

Team Name: .

R ider 1 T eam C aptain or S olo R ider Name: F irs t L as t G ender: Male F emale Age: B irthday: Addres s (mailing): . C ity S tate Zip . E mail addres s : T elephone: ( ) - . R ider 2 Name: F irs t L as t

Age: B irthday: Addres s (mailing): . C ity S tate Zip . E mail addres s : T elephone: ( ) - . R ider 3 Name: F irs t L as t

Age: B irthday: Addres s (mailing): . C ity S tate Zip . E mail addres s : T elephone: ( ) - . R ider 4 Name: F irs t L as t

Age: B irthday: Addres s (mailing): . C ity S tate Zip . E mail addres s : T elephone: ( ) - .

G ender: Male F emale

G ender: Male F emale

G ender: Male F emale

R ac e Number

S olo Male

S olo F emale

S olo S S XXXX XXXX

Duo T eam XXXX

Open T eam XXXX XXXX

F emale T eam XXXX XXXX

To receive a $5 discount, pre-registration formsmust be postmarked 7 days prior to the event date.Note: High School Div. is excluded from a $5 discount.

HighS c hool

Divis ion*(Ages 15-18)

XXXX

XXXX

XXXX

XXXX

$15 perR ider

To receive a $10 discount, register for the Series andsend in pre-registration forms must be postmarked7 days prior to the race date.Note: High School Div. is excluded from a $10 discount.

S hortDis tanc e*

$30 perR ider

MediumDis tanc e*

$40 perR ider

L ongDis tanc e*

$40 perR ider

* Distance based on Hours or Miles per individual Events.

WWW.WEMSERIES.COM

2011

Presented By

Product Sponsors

WWW.FRS.COM

R ider 1 T eam C aptain or S olo R ider S igned: T oday’s date: . E mergency C ontact E C P hone: . G uardian S ignature for participants under 18: . R ider 2 S igned: T oday’s date: .E mergency C ontact E C P hone: . G uardian S ignature for participants under 18: . R ider 3 S igned: T oday’s date: .E mergency C ontact E C P hone: . G uardian S ignature for participants under 18: . R ider 4 S igned: T oday’s date: .E mergency C ontact E C P hone: . G uardian S ignature for participants under 18: .

WAIV E R S MUS T B E S IG NE D B Y AL L R IDE R S E mergenc y C ontac t needed for all riders

Minors need a parent or guardian s ignature

2011 Wisconsin Endurance Mountain Bike SeriesAccident Waiver and Release of LiabilityI understand that there are inherent and other risks of injury or death involved in the sport of mountain biking and participants of such events, that injuries are a common and ordinary occurence of this sport and such participants that death may occur, and I freely assume all such risks of injury and death including but not limited to those presented by the layout of the track or course, and all other conditions of the course, vehicular, motorcycle, ATV, bicycle and other traffic, participant activity, first aid or rescue operations, domestic and wild animal attacks, and course conditions. In consideration of being permitted to participate in any of the WEMS (Wisconsin Endurance Mountain Bike Series) mountain bike events including but not limited to "Stump Farm 12", "12 Hours of Northern Kettles", "Muir South Kettle Classic", "Thunderdown in the Underdown", "Levis/Trow 100", "Washburn Rock'n Root", "Blue Mound Enduro", "12 Hours of Pitch Black Singletrack", "Wisconsin Endurance Championship Event - Levis/Trow" (here in after referred to as the listed WEMS events), I, personally and on behalf of my heirs, personal representatives, successors and assigns, herby release, waive, discharge and covenant not to sue all organizers, promoters, sponsors, participants, the promoting clubs, the officials, the volunteers, private land owners, and any involved municipalities or public entities (and their respective agents and employees), and all other persons and associations connected with any of the listed WEMS events and all of their officers, directors agents, employees, predecessors, successors, sponsors, exhibitors, vendors, and assigns (here in after referred to as the released parties) for any and all injuries and damages and/or death caused by the negligence of the released parties. I also understand that I am required to wear a helmet and stay properly hydrated.I have read and I voluntarily sign this agreement and I understand that by signing it, I personally, and on behalf of my heirs, personal representatives, successors and assigns, I am giving up all rights that I might otherwise have to make claims against the released parties for their negligence in causing injury or death sustained by me as a result of my participation in any of the listed WEMS events. I further release all rights to my image or account of my participation in any of the listed WEMS events and grant the listed WEMS events, the event promoter, his/her staff, volunteers, and any sponsors connected with the listed WEMS events permission to publish any photo, video, written, or audio accounts of my participation without expectation of any form of compensation. C: 03/19/11

No Refunds or Exchanges

Long Distance Events:

Open T eam, W omen’s T eam, Duo T eam, Men & W omen S olo, and S olo S ingle S peed Medium Distance Events:

Duo T eam, Men & W omen S olo Short Distance Events:

Men & W omen S olo

Individual R ace Information

#1 May 14, 2011 S tump F arm 12 R eforestation C amp G reen B ay W I Melis s a Dupke melis s a@ trikes2bikes .com 920-609-8985 Make checks payable to: T rikes to B ikes & More Attn: S tump F arm 12 5286 W arehouse Drive New F ranken W I 54229

#4 J uly 2, 2011 T hunderdown in the Underdown Underdown R ec Area Merrill W I T ed T augtes thunderdown12@ hotmail.com (715) 581-0012 Make checks payable to: T ed T autges c/o C hris S chotz W 2611 Yanda Ave G leas on W I 54435

#7

#2 May 28, 2011 12 Hours of the Northern K ettles G reenbus h T rails G reenbus h W I B rittany Nigh brittany@ brittanynigh.com 262-573-9083 Make checks payable to: T eam P edal Moraine c/o B rittany Nigh 4062 B avarian Ln W est B end W I 53090

#5 J uly 16, 2011 Levis /T row 100 Levis T row Mound Hatfield W I J ason P lansky biker24solo@ gmail.com (715) 212-5711 Make checks payable to: C hains mokers c/o J ason P lansky 3407 S kylark Ln W ausau W I 54401

#8 S eptember 3, 2011 T welve Hours of P itch B lack S ingle T rack C am-R ock C ounty P ark R ockdale W I C oleman R etzlaff cole_retzlaff@ yahoo.com Make checks payable to: V iking B iking C lub c/o C oleman R etzlaff 604 E Main S t Mt Horeb W I 53572

#3 J une 18, 2011 Muir S outh K ettle C lass icJ ohn Muir T rails La G range W I K enny Dretzka kdretzka1@ wi.rr.com (414) 339-4781 Make checks payable to: T eam C yclopaths c/o K enneth Dretzka 654 Heron Dr Mukwonago W I 53149

#6 Augus t 13, 2011 Washburn R ock'n R ootWashburn T railsR hinelander WIAl J ozwiakbikesnboards@ frontiernet.net(715) 369-1999Make checks payable to: R AS T Ac/o Al J ozwiak1670 N S tevens S tR hinelander WI 54501

#9

To rec eive the $5 dis count, regis tration forms mus t be pos tmarked 7 days prior to

the date of the event you are entering.

REGISTER FOR THE SERIES AND SAVE!

October 1, 2011Wisconsin E ndurance S eriesC hampionship at Levis/T rowHatfield W I J ason P lansky biker24solo@ gmail.com (715) 212-5711 Make checks payable to: WE MS c/o J ason P lansky 3407 S kylark Ln W ausau W I 54401

Augus t 20, 2011B lue Mound E nduroB lue Mound S tate P ark B lue Mounds W I K evin Las t kdlas t@ gmail.com Make checks payable to: W OR B A c/o K evin Las t 190 S B urr Oak Ave Oregon W I 53575

High School Division Events:Men & W omen S olo (limited for ages 15-18 Only)