the compassion to care, the leadership to conquer local families served by the Non-refundable Race Entry Fee of$25per person (limited to the frst 200 people) INCLUDES ALL DAY LIFT TICKETon the day of the race, with PRE-REGISTRATION. (Entry fee benets the Alzheimer’s Association) Pre-registration ends at 5:00 pm onTuesday, January6, 2009 Tickets may also be purchased on the day of the event for the standard liftticketprice of $48.00 plus the $25 Race Entry Fee. Helping Alzheimer’s Association Hudson Valley/Rockland/Westchester, NY Chapter* Register early. This offer applies to the rst 200 registrants only. Come join us for a special “Alzheimer’s Day Breakfast” starting at 8am. $10-$15 per person. ($10 tax deductible donation) 1-800-872-0994 www.alz.org/hudsonvalley registration: 8am - 10am race begins: 10:30 am location: Belleayre Mountain Ski Resort Highmount, NY To receive a pre-registration application or for more information contact 6th Annual Grand Slalom Challenge Snowboarders are welcome. A Race To RememberSunday , Januar y 11, 2009 & are proud to present
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RACE INFO: Sunday, January 11, 2009, 10:30 a.m. Race check-in will be from 8:00 a.m. to 10:00 a.m. on the
day of the race at the Upper Lodge at Belleayre Mountain. The race will be a grand slalom and challengers will bescored on the best time of two runs.
* BEGINNERS and SNOWBOARDERS WELCOME *
Please join us for the special “Alzheimer's Day” Breakfast – 8AM
CATEGORIES: Medals will be awarded to the first, second and third place finishers in all categories.
ALL RACERS MUST WEAR HELMETS
Girls6-8 years of age
Boys6-8 years of age
Girls9-12 years of age
Boys9-12years of age
Girls13-18 years of age
Boys13-18 years of age
Women19-34 years of age
Men19-34 years of age
Women35-49 years of age
Men35-49 years of age
Women
50 years of age +
Men
50 years of age +
HOW TO REGISTER:1. Fill out the reservation form, listing all members of your group2. Have each participant complete the attached Waiver 3. Mail the completed Reservation/Waivers Form by 5pm Tuesday, January 6th 2009 with the
nonrefundable pre-registration contributions of $25.00 per person/Race Entry to:Alzheimer’s Association2 Jefferson Plaza, Suite 103Poughkeepsie, New York 12601-4027
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FAX (845) 471-8960
• All checks should be made out to Alzheimer’s Association
• Reservations using major credit cards (Visa, Master Card, American Express & Discover), can beaccepted over the phone by calling 1 (800) 872-0994
• The $25 registration fee is fully tax-deductible
PRE-REGISTERED RACERS DO NOT NEED TO BUY A LIFT TICKET: Belleayre Mountain will
provide lift tickets at check-in on the day of the event to ALL REGISTERED PARTICIPANTS (Upper Lodge,Belleayre Mountain Ski Resort, between 8:00 am – 10:00 am on Sunday, January 11, 2009). *Event participants whodo not pre-register by 5:00 pm on Tuesday, January 9, 2009 must purchase a full price lift ticket ($48.00) in addition tothe $25 Race Entry Fee.
All proceeds from the $25.00 per person Race Entry Fee/Donationwill benefit the families served by the Alzheimer’s Association,
Each participant in this event must complete & sign this waiver and return it to the Alzheimer’s Association, HudsonValley/Rockland/Westchester, NY Chapter prior to the start of the event , to qualify for the lift ticket provided by Belleayre Mountain during
registration/check-in.
AMOUNT DUE: $_________ ($25 each IF received on/before 5pm 1/6/09 ~ $68 each if received after 5pm 1/6/09)$_________ Breakfast (additional $15)
____ Unfortunately, I will not be able to attend, but I have enclosed a $__________ donation to help local Alzheimer families andto help MOVE us closer to a world without Alzheimer’s disease!
____ I have enclosed a check for $_________, made payable to Alzheimer’s Association - Chk#:________ Chk Date:_________
____ I authorize the Alzheimer’s Association to charge $___________, to my credit card below:
AmEx MasterCard Visa Discover CARD #__________________________________
Authorizing Signature: ______________________________________________________________________ *Payment Information: (all payments are nonrefundable)*
Release: I understand that skiing and snowboarding are sports with inherent risks and that by racing (or otherwise using the day-long lift ticket associated with this event), I am increasing my (mychild’s) risk. I do hereby release and discharge the Alzheimer’s Association, Clear Channel, and Belleayre Mountain Ski Center, its Ski School, and all other sponsors and their representatives andsuccessors from all claims of damages, actions and causes of action arising out of my (my child’s) participation in this race &/or use of the day-long lift ticket associated with this event. I certify that Iam (my child is) physically fit and qualified to participate in this race & or to use the lift t icket associated with this event.
I further understand that I (my child) might be photographed while participating in this event. I hereby authorize the reproduction of any pictures that might be taken of me (my child), whether they arestill or video. I hereby waive all right to compensation for the use of any picture taken, regardless of type of use or exposure chosen. I place no restriction of the use of any photographic likenessand agree to hold harmless all individual photographers assigned as well as discharge the Alzheimer’s Association, Clear Channel,and Belleayre Mountain Ski Center, its Ski School, and all other sponsors and their representatives and successors.
Applicant Signature:*To be signed by parent or guardian if applicant is under 18 years of age.