1999 Barkley Application Name _____________________________________________________________________ Address ____________________________________________________________________ ___________________________________________________________________________ Age ____________ Sex (Y/N) ______________ Hat Size ____________________________ Favorite Parasite ______________________________________________________________ Preference of Disposition of Remains: _____________________________________________ I can offer no reasonable explanation for even wanting to ATTEMPT the Barkley. But it is my own stupid idea. I realize that REAL challenges come with REAL hazards. I ACCEPT that NOTHING will be done to assure my safety and well-being . As a matter of fact, that is how I want it. I take full physical, financial, and emotional responsibility for the outcome of my own Barkley run. Signed: _______________________________________________ Date: ____________________ Witness: _______________________________________________