Irving Woodlands CAC 250 Willard Jalbert Jr. CAC 60 Pepsi CAC 30

OFFICIAL ENTRY FORMS

CAN-AM CROWN

INTERNATIONAL SLED DOG RACES

March 6, 2010


It is acceptable to print the blank forms, then fill them out manually.
However, we prefer that applicants use a computer to fill out the forms.
Data will then be much easier for Can-Am Crown to read and process.

Musher application must include:

  • Valid payment of the full entry fee
  • Completed and signed entry form (Page 1)
  • Completed Pages 2, 3, 4, and 5.
  • Signed waiver (Page 6) from parent or guardian if musher is a minor

Applicants will not be accepted and bib numbers will not be held until
Can-Am Crown receives all of the required completed documents
and full payment of the entry fee.

Can-Am Crown reserves the right to accept or reject any entry
and may honor the censures of another sled dog racing organization.



[2010] CAN-AM CROWN RACE ENTRY APPLICATION [Page 1]

Team Owner
   Website URL
  

Team Driver
  Email Address
  



  Home Address of Team Driver  Training Address
Line 1    
Line 2    
City    
State/Prov    
ZIP/P.Code    

Phone Number
Which race?

Make checks payable to "Can-Am Crown, Inc.".
There will be a $20 service charge for returned (bounced) checks!
For credit card payments, call (207)834-5626 or mail your cc number with this application.
After completing and signing this application, mail pages 1, 2, 3, 4, 5, and 6 (if a minor) with payment to:
CAN-AM CROWN, INC.
P.O. BOX 171
FORT KENT MILLS, ME 04744

or fax the pages to (617) 208-2449.

Applications may be mailed or faxed any time after August 1.

You are not registered until full payment and all 5 (or 6, if a minor) pages are received and approved.

Each race will be limited to 30 teams.

Entry Fees: All fees and refunds are in U.S. funds only.

CAC250: The entry fee is $300. Any entrant who withdraws before January 1 will receive a $150 refund.
CAC60: The entry fee is $175. Any entrant who withdraws before January 1 will receive a $90 refund.
CAC30: The entry fee is $125. Any entrant who withdraws before January 1 will receive a $60 refund.
Between January 1 and January 31 refunds are reduced daily according to schedules which are included in the race rules.

AGREEMENT: I agree to abide by the Can-Am Crown race rules, and I hereby acknowledge that I have received, read and understood the rules. I agree to allow my team to be tested for the use of unauthorized drugs. I agree that the race marshal is the final arbitrator of the race and that I shall abide by his/her decisions. I further agree to release the sponsors, race managers, and other individuals associated with the race from any claim or demand resulting from injury or accident, damage or loss to myself, my dogs or my equipment which may occur during the race. I agree that Can-Am Crown, Inc. and the race sponsors shall have free authority to photograph and otherwise collect information about the race and all participants therein and to use such photographs and information for advertising, public relations, brochures, posters, or other publicity.

Team Owner __________________________________________________ Date ____________________

Team Driver __________________________________________________ Date ____________________

Both owner and driver must sign.

For more information (French or English): Call Can-Am Central (207) 834-5626
E-mail:  tad@sjv.net    Can-Am Crown website:  http://can-am.sjv.net

[2010] CAN-AM CROWN RACE ENTRY APPLICATION [Page 2]

PROFILE


BirthBirthBirth
DriverMonthDayYear(yyyy)SexAge
  

Occupation:

NAMES OF LEAD DOGS
BREED
SEX
AGE

Keep the race fans happy! Please write a bio for the Can-Am website.
Write at least 30 words, but no more than 300. We will proofread and edit as needed.

[2010] CAN-AM CROWN RACE ENTRY APPLICATION [Page 3]

Name  

EXPERIENCE

Experience is required for entry into the 250-mile race.
Can-Am Crown reserves the right to accept or reject any entry.
However, we will generally accept applicants who have achieved one or more of the following goals within the last three years (2007 or later):
  • Finished a race of 200 miles or more in good standing, or
  • Finished in the top two-thirds (67%) in a sled dog race of 100 miles or more, or
  • Finished in the top two-thirds (67%) in the Can-Am Crown 60.
No race or portion of a race will qualify if you did not finish the entire race.

Name of longest sled dog race you have ever finished
 Year
 Distance
 Entries
 Rank

List some significant sled dog races that you have finished in recent years (2007 and after).
Include mileage (Distance), your finish place (Rank), and the total number of competitors (Entries) in the race.

Name of RaceYearDistanceEntriesRank


Other dogsledding experience:

[2010] CAN-AM CROWN RACE ENTRY APPLICATION [Page 4]

Name:   Race  

When will you arrive? 
Who will be with you? 

A personal handler is required for 250-mile teams.
Personal handlers shall pick up dropped dogs at Portage, Allagash, and/or Fort Kent.

(Required)
 Handler's name & cell phone# 

Please list other teams that may be using the same vehicle.

 Other Musher   Race 

 Other Musher   Race 

Where do you plan to stay during the race? 

For commercial lodging in the area, see our list at  http://can-am.sjv.net/Travel.htm
If you prefer to stay with a host family, please let Karen Ouellette know as soon as possible.
If you contact her early, Karen can usually find households to accommodate drivers and their teams.

Would you like to lodge with a host family? If "Yes", please e-mail karenouellette@roadrunner.com as soon as possible
even if you plan to make your own arrangements with a host family.
Please be considerate of host families by limiting yourself to two guests (you and your handler),
unless you are positive that the host family would be happy to accommodate more.
Host families should not be expected to provide accommodations before Thursday or after the last day of the races.

Lodging preferences? 

Substitute Drivers

If no alternate is named at least 30 days before the race, then no substitution of drivers will be allowed!

If you become unable to start the race, one of the alternates you have named may substitute for you.

Alternate #1
Alternate #2
Name    
Email    
Telephone    
Address    

[2010] CAN-AM CROWN RACE ENTRY APPLICATION [Page 5]


This CONFIDENTIAL page is for use only by race organizers and medical personnel.


Team Driver
  Email Address
  



  Home Address  Training Address
Line 1    
Line 2    
City    
State/Prov    
ZIP/P.Code    

Phone Number
Which Race?
  


Please list any of your medical conditions which Can-Am organizers or medics might need to know, such as diabetes, epilepsy, asthma, allergies, back or neck problems, etc.

Please list any drugs you are currently taking, or which you will be taking during the race.


[2010] CAN-AM CROWN RACE ENTRY APPLICATION [Page 6]





PARENT/GUARDIAN CONSENT



Applicant is more than 18 years old.

Parental consent is not required.

Go to the next page.

If applicant is a minor (less than 18 years old),
then this document must be signed by parent/guardian and minor.


I,  , hereby grant permission to allow

(my child or charge) to race in the

CAN-AM CROWN -MILE SLED DOG RACE.

I also hereby certify that I am the parent or legal guardian of this minor.
I will take full responsibility and indemnify Can-Am crown, Inc. for any unforseen events that may cause harm to this underage participant.



Parent/Guardian Signature ______________________________________ Date _____________


Minor Signature ______________________________________________ Date ______________



VACCINATION INSTRUCTIONS ---- CAN-AM CROWN RACES ---- March 6, 2010

  All dogs entered in the race must be vaccinated against
distemper, hepatitis (adenovirus 2), leptospirosis, parainfluenza, and parvovirus
at some time after March 6, 2009 and before February 13, 2010.

All dogs must be vaccinated against rabies some time before February 13, 2010.
Rabies certificates must not expire before March 10, 2010.
Validated rabies certificates must be presented to prove that rabies vaccinations are current.
In accordance with current Maine law, three-year rabies vaccinations are now accepted.

  Bordetella and Coronavirus immunizations are recommended, but not required. Owners should consult with a veterinarian for proper timing of these optional vaccinations.

  Vaccination is required against the leptospirosis serovars (strains) L. canicola and L. icterohaemorrhagiae. Leptospiral vaccines generally provide protection from these two serovars. However, infection by two other serovars, L. grippotyphosa and L. pomona, is becoming more common. Therefore, Can-Am Crown recommends vaccination against these two additional serovars.

  See pet education and working dogs for an explanation of the leptospirosis problem.

  Copies of proofs of vaccinations must be included with the completed Uniform Canine Vaccination Record (UCVR).
(Owners who vaccinate their own dogs shall submit purchase invoices as proof of vaccination within the prescribed time period.)

The Uniform Canine Vaccination Record is in pdf format, readable by Acrobat Reader 4.0 or better.
To download the form, click this button:

Be sure to set your printer for landscape orientation before printing the UCVR!

It is not necessary to submit vaccination records at the same time as your entry forms.
Please wait until all vaccinations are complete and in compliance with the race rules.
Please do not submit vaccination records before February 1!

ASAP AFTER FEBRUARY 1:

Submit copies of proofs of vaccination and the completed UCVR by mail to:

CAN-AM CROWN, INC.
P.O. BOX 171
FORT KENT MILLS, ME 04744

or by fax to (617)208-2449


As insurance, please bring duplicate copies of vaccination proofs with you to the pre-race veterinary examination.

PLEASE REVIEW PROOFS BEFORE FEBRUARY TO ALLOW TIME FOR UPDATING VACCINATIONS IF NECESSARY!


Copyright 2009 by Can-Am Crown inc. - ALL RIGHTS RESERVED