A new addition to the Laverne Main Street Lucky Duck race is the

							                     A new addition to the Laverne Main Street Lucky Duck
race is the Tour de Duck. The Tour de Duck bicycle race will consist of three
different courses.

The 10-mile bicycle race will begin at the Post Office at 5:30 pm going south on
Oklahoma to Bud’s Trail, following the trail back to Jane Jayroe and then
heading west to the turn-around and finishing back on Main Street.

A 3-mile trail ride will make it’s way south on Oklahoma to Bud’s Trail,
following the entire trail back to the park and finishing on Main Street.

The 1-mile fun ride and stroller derby will leave the Post Office south to David
Terry, CPA, then turning around and finishing back at the Post Office.

Prizes will be awarded to the top 3 finishers in each age division of the race.

Registration and packet pickup begins at 4:45 pm at the Post Office on July 3rd.

Entry fees prior to June 28 are $20 for adults, $15 for students, and free for
children 10 and younger. Race day fees are $25/adults, $20/students. All adult
and student bicyclists will receive a T-shirt with their registration fee. In order
to secure a t-shirt, pre-registration is highly encouraged. Those registering the
day of the event are subject to limited t-shirt supplies available at that time.

For more information contact Aaron Elam at (580)-273-3526. Registration
forms can be found at www.lavernemainstreet.com or picked up in the Laverne
Main Street office.

Proceeds will benefit Laverne Main Street downtown community revitalization
efforts.
                                                              Tour de Duck
                                           Laverne Main Street’s
                                           10 Mile Bicycle Race
                                                              3 mile trail ride
                                             1 mile fun ride/stroller derby
                                                                Entry Form
Name___________________________________________________        M or F _________             Age on Race Day
_____________________
Address ________________________________________ City __________________________ State __________ Zip ___________
Phone # ________________________________ Email Address ________________________________________________________

Fees:
Adults - $25 race day, $20 if pre-registered by June 28. Students - $20 race day, $15 if pre-registered by June 28. Youth 10 and Under - Free

Age Division: (circle one)
                                            10 and Under Youth      11 to 18 Student       19 and Over Adult

T-Shirt Size - Adults and Students only: (circle one)
                                                        Sm.      Med.       Lg.     XL       XXL
Disclaimer:
I know that participating in a bicycling event is a potentially hazardous activity. I should not enter and or otherwise participate unless I
am medically able and properly trained. I also know that there will be a possibility of vehicle and other traffic on the same course that
this event will take place. I assume the risk of participating in this event when motor vehicles are present on the course. I also assume
any and all other risks associated with participating in this event, including, but not limited to, heart failure, stroke, trauma, falls, contact
with other participants, the effects of the weather and the conditions of the roads, all such risks being known and appreciated by me.
Furthermore, I agree to yield to all emergency vehicles. I also am fully aware that wheels of any kind (except bicycles, competitive
wheelchairs and baby strollers), animals and head phones are strictly prohibited and I agree not to have them on the course. I agree not
to go back onto the course after finishing. Knowing these facts, and in consideration of your accepting my entry, I hereby for myself,
my heir(s), executors, administrators or anyone else who might claim on my behalf, covenant not to sue, and/or waive, release and
discharge any and all race sponsors, race officials, volunteers, local and state police including any and all of their agents, employees,
assigns or anyone acting for or on their behalf for any and all claims or liability of death, personal injury or properly damage of any kind
or nature whatsoever arising out of, or in the course of, my participating in the event whether same be caused by negligence or fault.
This release and waiver extends to all claims of every kind or nature whatsoever, foreseen or unforeseen, known or unknown. The
undersigned grants permission to sponsors and/or agents authorized by them to use any photos, video tapes, motion pictures, or any
other record of the event for LMS purposes. Minors accepted only with a parent or guardians signature.

Signed (Parent or Guardian if under 18) ______________________________________________ Date________________________
                                                           (Wavier must be signed to participate)

Checks made payable to Laverne Main Street. Pre-registration deadline June 28. Mail or drop off registration form to: Laverne Main
Street, PO Box 634, Laverne, OK 73848, to secure a t-shirt. Entry forms can also be obtained at laverneymainstreet.com. Registrations
taken day of race will receive a t-shirt if supplies allow.
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Office Use Only:
Cash_______________ Check # _____________ Date Paid _________________________ Amount __________________