Southwestern Health System Foundation
presents
The Eighth Annual
"About Two Hours from Anywhere"

Time Trial, Road Race and Criterium

  9th Annual Bike Race
September 23 - 25th, 2005

Murphy - Andrews - Hayesville, NC

USCF Permit Applied for

LATE FEES WILL BE ENFORCED GET YOUR ENTRY IN BY SEPT 16th

You will need to print this out and mail it to the address at the bottom.
Group Housing available Contact Linda May - 828-835-7624 or email LMay@murphymedical.org

Entry Fees
Includes USCF surcharges

Category	TT	RR	Crit	All
Pro 1,2	$15.00	25.00	25.00	$60.00
Cat 3	$15.00	25.00	25.00	$60.00
Junior	$10.00	20.00	20.00	$45.00
Cat 5	$10.00	20.00	20.00	$45.00
All other	$10.00	25.00	25.00	$55.00

Cycling Registration Form

Category __________         Racing Age __________

Races
              Time Trial _______              Road Race ________              Criterium ________

Entry Fee from Chart Above _________

Late Fee @ $5 per event           _______
               After Sept 16, 2005
$5 unattached fee                   _______

                                          Total ________

Name: ____________________________________________

Address: __________________________________________

City, St, Zip: _______________________________________

Phone: Hm _______________ Wk ____________________

USCF License # ______________ Expires: ______________

Club/Team: ________________________________________

Emergency Contact
Name: _____________________ Phone: ________________

Make checks payable to SHS Foundation.

Mail to: Southwestern Health Systems Foundation
              Attn: Linda May
              4130 Highway 64 East
              Murphy, NC 28906

PDF flyer for registration click here.