The 2021 Wilderness 101 Backcountry Race
Coburn. PA| Saturday July 24,th 2021
R E G I S T R A T I ON

Please print, fill-out, clip and send this registration along with a non refundable check made out to: Shenandoah Moutain Touring, L.L.C. - thanks SMT

Registration is now open and online at Bikereg.com- or you can print and
mail this form with a check.

Early Registration is $140 -<$100 marathon> must be postmarked before April 17th, 2021 - ends 16th online
Regular registration is $160 - <$120 marathon> must be postmarked before May 22rd, 2021 - ends 21st online
Late Registration is $180 - <$140 marathon> if postmarked before June 17th, 2021 - ends 18th online

Last minute registration after 11:00 PM June 18th -- online only -- $200
<$160 marathon>

No Refunds
Transfer to another person $30 - prior to June 1st
Transfer to another person $50 - from June 1st to July 1st
NO TRANSFERS after July 1st
Picture ID/License required at rider check in
We do not carryover entries to another year

Mail to:

Shenandoah Mountain Touring, L.L.C.
P.O. Box 1423
Harrisonburg, VA 22803

Name:__________________________________________________

Age: ________ M/F:_______ Email:__________________________

Street: _________________________________________________

City: ___________________________________ State: __________

Zip: __________________ Shirt Size:_________________________

Phone: Cell# ___________________ Home #____________________

Emerg #________________ Master 50+? ___ Clydesdale 200lb+ ____

Main Sponsor _________________________ Singlespeed ? ________1/01/2018