09 Application

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0><script type="text/javascript" src="http://hb.lycos.com/hb.js"></script> <script type="text/javascript" src="http://ratings.lycos.com/ratings/lycosRating.js.php"></script> <script type="text/javascript"><![CDATA[//><!]]></script> <script type="text/javascript" src="http://scripts.lycos.com/catman/init.js"></script> <script type="text/javascript" src="http://members.tripod.com/adm/ad/code-start.js"></script> <script type="text/javascript" src="http://members.tripod.com/adm/ad/code-middle.js"></script> <script type="text/javascript" src="http://members.tripod.com/adm/ad/code-end.js"></script> <noscript> <img src="http://members.tripod.com/adm/img/common/ot_noscript.gif?rand=194098" alt="" width="1" height="1" />  <iframe frameborder="0" marginwidth="0" marginheight="0" scrolling="no" width="728" height="90" src="http://ad.yieldmanager.com/st?ad_type=iframe&ad_size=728x90&section=209094"></iframe>  </noscript> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=90 BGCOLOR="#006699" TEXT="#080000" background="042fd5a3.jpg"> <div> <FONT SIZE="5" COLOR="#000000" FACE="Arial" ><B>Knik 200</b></FONT><B>    </b><B> |     </b><A HREF="index.htm" TARGET="_top" TITLE="Knik 200"><U><B>home</b></U></A></div> <div> <B>09 Application</b>   |   <A HREF="id23.htm" TARGET="_top" TITLE="Sponsors"><U>Sponsors</U></A>   |   <A HREF="id21.htm" TARGET="_top" TITLE="09 Mushers!!"><U>09 Mushers!!</U></A>   |   <A HREF="id22.htm" TARGET="_top" TITLE="Volunteers for the Knik 200"><U>Volunteers for the Knik 200</U></A>   |   <A HREF="id16.htm" TARGET="_top" TITLE="Rules"><U>Rules</U></A>   |   <A HREF="id17.htm" TARGET="_top" TITLE="Contact Us"><U>Contact Us</U></A>   |   <A HREF="id18.htm" TARGET="_top" TITLE="Race Archive"><U>Race Archive</U></A>   |   <A HREF="id19.htm" TARGET="_top" TITLE="Pictures from the past........."><U>Pictures from the past.........</U></A>   |   <A HREF="id20.htm" TARGET="_top" TITLE="Trail News"><U>Trail News</U></A></div> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#FFCC66" TEXT="#080000" background="043d2b03.jpg"> <div> <IMG SRC="045b0e70.jpg" border=0 width="176" height="231" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <div> Joe Redington Sr.</div> <bR> <DIV ALIGN="LEFT"></DIV> <div>   <script type="text/javascript"> sc_project=2391633; sc_invisible=1; sc_partition=22; sc_security="1f0f9b7f"; </script> <script type="text/javascript" src="http://www.statcounter.com/counter/counter.js"></script><noscript><div class="statcounter"><a title="hits counter" href="http://www.statcounter.com/" target="_blank"><img class="statcounter" src="http://c23.statcounter.com/2391633/0/1f0f9b7f/1/" alt="hits counter" ></a></div></noscript>   </div> <div> Thank you to our 2009 Sponsors:</div> <div> Houston Chamber of Commerce presents:</div> <div> <IMG SRC="0608d8d0.jpg" border=0 width="141" height="141" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <div> <A HREF="http://www.matsupikederby.com" TARGET="_top" TITLE="http://www.matsupikederby.com"><U>Mat-Su Pike Derby Feb.1 -March 31 2009 </U></A></div> <div> Mat-Su Air Service </div> <div> Rod Ewing </div> <div> The Dog Wash </div> <div> Tony Turinsky </div> <div> Rosen Kennels </div> <div> Glacier Aircraft Parts </div> <div> Flysafe B&B Airventures </div> <div> Knik Country Liquor, Inc. </div> <div> Ray Hollenbeck </div> <div> Janssen Funeral Homes, Inc. </div> <div> Lou Schader</div> <div>  KI1IL</div> <div>  KNIK BAR </div> <div> Settlers Bay Lodge</div> <div> BONNIE </div> <div>  Point Mackenzie General Store</div> <div>  Valley Block</div> <div>  Cedarhome Ins.</div> <div>  D's Screenprinting</div> <div>  Shamrock</div> <div>  Gary Paulsen</div> <div>  Kelly Wolf-trail crew #00</div> <div>  John Schrader & family</div> <div>  Knik Kountry Liquor</div> <div>  TUNDRA Dog Extraordinaire</div> <div>  K&K, Inc.</div> <div>  AAFW</div> <div>  Kevin Wellington DVM</div> <div>  Fisher's Fuel</div> <div> Sponsors please send logos to houstonakchamber@hotmail.com for inclusion on the website.</div> </td> <td valign="top" height=390 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <I>09 Application</I></div> <div> <B>APPLICATION</b> </div> <div> <B>Send to Knik 200 Race Committee</b> </div> <div> Checks to: P.O. Box 872327, Wasilla, AK 99687 </div> <div> <B>(907) 376-0627</b> </div> <div> SECTION I- PERSONAL BACKGROUND INFORMATION </div> <div> (Please Print) </div> <div> Name _______________________________________ Social Security Number ______-_____-______ </div> <div> Permanent Address _______________________________ Phone Number ______-_____-______ </div> <div> Training Address ________________________________ Phone Number ______-_____-______ </div> <div> Sex (M/F) ______ Date of Birth ______ Birth State _______________ Marital Status ______________ </div> <div> Name and ages of children _______________________________________________________________ </div> <div> Came to Alaska from _________________ When ____________ Why ____________________________ </div> <div> SECTION II- PROFESSION, ORGANIZATIONS AND HOBBIES </div> <div> Present Occupation _________________________________________________ How Long __________ </div> <div> Employer _________________________ Organizations & Hobbies ______________________________ </div> <div> ______________________________________________________________________________________ </div> <div> ______________________________________________________________________________________ </div> <div> SECTION III- MUSHING BACKGROUND </div> <div> Began Mushing _______________ How did you first become interested in the Knik 200 _____________ </div> <div> ______________________________________________________________________________________ </div> <div> Previous race record ____________________________________________________________________ </div> <div> (race, year , placement) </div> <div> Other race experience ___________________________________________________________________ </div> <div> SECTION IV- GENERAL INFORMATION </div> <div> Include a statement about yourself, your background, your dogs and reasons for entering the Knik 200. If you need more room, please attach additional information on a separate sheet of paper. </div> <div> ______________________________________________________________________________________ </div> <div> ______________________________________________________________________________________ </div> <div> ______________________________________________________________________________________ </div> <div> ______________________________________________________________________________________PLEASE </div> <div> IT IS UNDERSTOOD THAT THE KNIK 200 RACE COMMITTEE, INC. HAS THE RIGHT TO USE INFORMATION FROM THIS APPLICATION FOR NEWS ARTICLES AND PRESS RELEASES. </div> <div> By signing this application and paying the required entry fee, the musher agrees to abide by the 2002 race rules,is aware of the risks and hazards inherent upon entering the race. Voluntarily assumes all risks of loss, damage, or injury that may be sustained while entered in the race. And releases the Knik 200 organizers from any and all liability,claims, demands, actions, and whatsoever arising out of or related to any loss or injury that may be sustained by the undersigned while participating in this race, or while in route to or from this race. </div> <div> Signature ____________________________________________________ Date ___________________ </div> <div> Please mark statements below that apply. </div> <div> I do not wish to have my phone number given out. _______ </div> <div> I do not wish to have my mailing address given out. _______ </div> <div> I do not wish to have my email address given out._________</div> <bR> <bR> <bR> <bR> <bR> </td> </tr></table></body>