Hosted by Vermont Adaptive Ski and Sports

VERMONT 100 ENDURANCE RUN
SERVICE REQUIREMENT REPORT FOR 2012

Before a runner may participate in the VT 100, he or she must meet the VT 100 Service Requirement. This requirement can be met by completing 8 hours of volunteer time (see next paragraph) OR paying a service buy-out  fee of $150.00. The buy-out can either be purchased via Active.com when you register or can be purchased later by sending a check with the  runners name and buy-out in the memo to VT100 Endurance Run, PO Box 612  Brownsville VT 05037. Like the Service Requirement, the buy-out needs to be postmarked no later than June 15th. 

The 8 hours of volunteer service must be completed at the VT 100, the VT 50 or in support of another ultra event 50 K or longer or other event  approved by the race director of the VT 100. This service must be completed in the 14 months preceding the race. The Vermont 100 always  accepts service requirements done for Western States. To complete this requirement:

1. Choose an event at which to volunteer. Contact the VT 100 race director with any questions about event eligibility.

2. Print out the form below, complete it and have it signed by an authorized representative of the event at which you volunteer.

3. Mail the form (following your online entry) to: VT100 Endurance Run, PO Box 612
Brownsville VT 05037, postmarked no later than June 15th, 2012.

YOUR SIGNATURE:________________________________________ DATE:______________

PRINT NAME:_________________________________________________________________

ADDRESS:____________________________________________________________________

E-MAIL ADDRESS: _____________________________________________________________

EVENT WORKED:_____________________________ LOCATION:_____________________

DATE OF EVENT:_______________ NUMBER OF HOURS WORKED:_____________

BRIEF DESCRIPTION OF THE WORK PERFORMED:_________________________________

______________________________________________________________________________

______________________________________________________________________________

Note: Work performed must be approved and assigned by race director, asst. race director or other event official for the benefit of the event. Volunteering for an individual competitor does not qualify.

CERTIFICATION

SIGNATURE OF AUTHORIZED PERSON:__________________________________________

PRINT NAME:_____________________________________________ DATE:______________

TITLE:________________________________________________________________________

ADDRESS:_____________________________________________________________________

PHONE:_____________________  EMAIL:______________________________________________

Enter on-line early and follow up by sending this service form not later than June 15th, 2012.