2005 WESTERN STATES ENDURANCE RUN
SERVICE REQUIREMENT CERTIFICATION FORM

Name___________________________________________________Date:____/____/____

Address:___________________________________ City:___________________________

State, Zip:__________________________ E-mail:_________________________________

This certification applies to the Western States Run for the year 2005.

Date service performed:____/____/____

Hours of service performed on this date: ________
(Submit one form for each date of service)

Brief description of trail work or volunteer services performed at a running race.  Include name of the run.

Certification of Ranger, Park Official, Race Director, Event Coordinator, etc:

Signature:_______________________Title:_________________Date:____/____/____
Telephone #:(____) _____  ______________

Guidelines:
•	Starting in 1998, the Western States Endurance Run has required eight hours of service.  
	This can be in the form of trail maintenance or volunteer services at any official running race.
	Pacing, crewing and volunteer coaching is NOT considered a volunteer service to an event. 

•	The eight (8) hours of service must be verified by an independent second party.

•	Please complete this form and have it certified by the appropriate person.

•	The volunteer service must be performed between March 1, 2004, and May 15, 2005.

•	This form must be received no later than June 1, 2005, or you will not be permitted 
	to participate in the 2005 WS 100.  No exceptions.

For confirmation of receipt, include a self-addressed stamped envelope.

This form may be photocopied.
 Send completed forms to:  
Western States Endurance Run, 2217 Ryedale Lane, Sacramento, CA 95835-2185   
For additional information call (916) 387-8796 or E-mail: wser100@comcast.net