| Registration form for the Ironhorse Ultra 100 |
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| First name | | |
| Last name | | |
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| Birthday - day/ month/ year | | |
| Gender | | |
| Address | | |
| City | | |
| Province | | |
| Postal Code | | |
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| Email Address | | |
| Home Phone | | |
| Cell Phone | | |
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| Emergency contact - name/ phone number | | |
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| Race / Event | | |
| 100 Km Solo | | |
| 100 Mile Solo | | |
| 100 Km Relay - name / team / captain | | |
| 100 Mile Relay - name / team / captain | | |
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| Shirt Size - men's - women's (M or L) | | |
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| Include this form with waiver form and cheque payable to "Ironhorse Ultra 100" |
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| 4925 - 45 Ave | | |
| St.Paul, AB | | |
| T0A 3A4 | | |