Entry Form
LAKE ERIE LOOP REGISTRATION FORM FOR LEL-XI, JUNE 5-7, 2015
PLEASE PRINT!!!

NAME___________________________________________________________________

ADDRESS_________________________________________________________________

CITY_______________________________STATE___________________ZIP__________

PHONE______________________________EMAIL________________________________

INSURANCE CO.___________________________________________________________

POLICY NUMBER______________________EXPIRATION DATE______________________

_____CLASS 1. UNLIMITED 50CC. IF IT STARTED LIFE AS A 50, IT'S ELIGIBLE. MUST
RETAIN THE ORIGINAL BOTTOM END, HOWEVER, ANY AFTER MARKET TOP END IS OK. I.E.,
A 70CC KIT ON A 50CC MOTOR. VINTAGE UP TO 110CC.
_____CLASS 2. 125CC SCOOTERS AND MOTORCYCLES. VINTAGE UP TO 160CC.
_____CLASS 3. 200CC SCOOTERS AND MOTORCYCLES, ALL CUSHMAN STYLE SCOOTERS,
VINTAGE UP TO 225CC.
_____MOPED CLASS. MOPEDS MUST HAVE PEDALS.
_____TOURIST CLASS. ANY SIZE, ANY BIKE.
ANY QUESTIONS ABOUT LEGALITY SHOULD BE SENT TO BILL MURAR AT THE ADDRESS
BELOW.
A VINTAGE BIKE WILL BE ANY BIKE 30 YEARS OLD OR OLDER.

INFORMATION ON YOUR ENTRY.

YEAR__________________________________MAKE______________________________

MODEL_________________________________SIZE IN CC'S______________________

-EACH ENRTY MUST BE STREET LEGAL WITH GOOD TIRES, A WORKING HORN, WORKING
LIGHTS (HEADLIGHT, TAILLIGHT AND BRAKE LIGHT) AND A WORKING ODOMETER. THESE
THINGS WILL BE CHECKED AT TECH ON FRIDAY, JUNE 20TH. DURING THE EVENT ALL
RIDERS ARE ENCOURAGED TO WEAR PROPER RIDING GEAR AND A HELMET. RIDERS WILL
NEED TO CARRY A PASSPORT TO ENSURE TROUBLE FREE TRAVEL AT
THE TWO BORDER CROSSINGS. AS THERE IS NO OFFICIAL ROUTE, NO CHASE TRUCK WILL
BE PROVIDED. IT IS UP TO EACH ENTRANT TO MAKE SURE THEIR VEHICLE IS IN THE
UTMOST OF READINESS AS THIS IS A LONG, DIFFICULT ENDURANCE RIDE.
DUE TO THE COMPETITIVE NATURE OF OUR PARTICIPANTS, CERTAIN SPECIFICS HAVE BEEN
LEFT OUT OF THIS REGISTRATION FORM. THESE ITEMS WILL BE MADE KNOWN SATURDAY
MORNING PRIOR TO THE FIRST BIKE OFF TO HELP ENSURE AN EVEN PLAYING FIELD.
-CAMPSITES FOR TWO PEOPLE WILL BE $25 FOR THE WEEKEND (FRI. & SAT. NIGHT)
INCLUDING AN ELECTRIC HOOKUP. IF YOU HAVE OVERNIGHT GUESTS THEY WILL BE AN
ADDITIONAL $4 PER PERSON. ALL MONIES FOR CAMPING WILL BE COLLECTED BY THE
CLARE-MAR LAKES STAFF. FRIDAY NIGHT DINNER WILL BE BURGERS, HOT DOGS,
POTATO SALAD, CONDIMENTS, SOFT DRINKS, ETC., SAT. NIGHT WE'LL HAVE SLOPPY
JOES, CHIPS, ETC. AND THE SUNDAY MORNING PANCAKE BREAKFAST WILL INCLUDE
PANCAKES, HAM, OJ AND COFFEE. COST FOR FOOD WILL BE $20 PER PERSON FOR THE
WEEKEND. DAILY GUESTS WILL PAY $7.00 PER MEAL.
-THE ENTRANT AGREES TO HOLD HARMLESS THE MURAR/NEELSEN PEDIATRIC BURN FUND,
CLARE-MAR LAKES CAMPGROUND, THE NORTHERN OHIO FIRE FIGHTERS, THE ACBC
FOUNDATION AND ANY AND ALL OTHERS ASSOCIATED WITH THIS RIDE, FROM ANY INJURIES
OR DEATH OR LIABILITY CLAIM INCURRED WHILE RIDING TO, DURING AND AFTER THE LAKE
ERIE LOOP RIDE.

SIGN NAME____________________________________________DATE________________





LAKE ERIE LOOP PRICES.

_____VEHICLE ENTRY $50
_____VEHICLE ENTRY TOURIST CLASS $25
_____MEALS $20 PER PERSON
_____TOTAL DUE

PLEASE SEND A CHECK OR MONEY ORDER TO:
THE MURAR/NEELSEN PEDIATRIC BURN FUND
42121 PECK WADSWORTH RD.
WELLINGTON, OHIO 44090