Entry Form
Memorial Day Triathlon, Duathlon, Footraces & Kids Mini-tri - Monday May 30, 2011
Mail completed entry form and fee to: Memorial Day Triathlon, Duathlon, Footraces & Kids Mini-tri, @ 9435 180th Way SW, Rochester, WA 98579, Elma, WA
(Please print)

Name (first)                           (last)
|__|__|__|__|__|__|__|__|__|__|__|__|  |__|__|__|__|__|__|__|__|__|__|__|__|
Address
|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
City                                   State         Zip
|__|__|__|__|__|__|__|__|__|__|__|__| |__|__| |__|__|__|__|__|
Phone                                      Sex        Age on Race Day
|__|__|__| |__|__|__| |__|__|__|__|       M    F         |__|__|

FEES: (You must order a shirt to receive one.):

Triathlon  (Before May 15)        $60.00  $ ______
Triathlon  (Before May 30)        $65.00  $ ______
Triathlon day of race             $70.00  $ ______
Triathlon team                    $80.00  $ ______
Duathlon   (Before May 15)        $40.00  $ ______
Duathlon   (Before May 30)        $45.00  $ ______
Duathlon day of race              $50.00  $ ______
Duathlon team                     $60.00  $ ______
Kids race                         $20.00  $ ______
Marathon   (Before May 15)        $60.00  $ ______
Marathon   (Before May 30)        $65.00  $ ______
Marathon day of race              $70.00  $ ______
Half-marathon (Before May 15)     $45.00  $ ______
Half-marathon (Before May 30)     $50.00  $ ______
Half-marathon day of race         $55.00  $ ______
10 miles   (Before May 30)        $35.00  $ ______
10K (6.2 miles) (Before May 30)   $25.00  $ ______
10K day of race                   $30.00  $ ______
5K (3.1 miles) (Before May 30)    $20.00  $ ______
5k day of race                    $25.00  $ ______
1 mile (Before May 30)            $18.00  $ ______
1 mile day of race                $20.00  $ ______
           Marathon maniacs       -$5.00  $ ______
           Short sleeve shirt      $5.00  $ ______
           Tank Top               $10.00  $ ______
           Long sleeve shirt      $10.00  $ ______
           Sweatshirt longsleeve  $15.00  $ ______ 

T-shirt Size (circle one): 
Adult S  M  L  XL   XXL
Child S  M  L  XL   XXL

Total enclosed                            $ ______


MAKE CHECK PAYABLE TO: Kristina Salazar, 9435 180th Way Sw, Rochester, WA 98579.

Waiver I HEREBY RELEASE THE PUGET SOUND CRUISERS, THE CITY OF ELMA, VANCE CREEK PARK, GRAYS HARBOR COUNTY, STATE OF WASHINGTON FOR ANY CLAIMS OR DEMANDS OF ANY KIND. I KNOW BY SIGNING THIS ENTRY FORM, I'M WAIVING MY RIGHT TO SUE FOR ANY AND ALL REASONS, INCLUDING BUT NOT LIMITED FOR PERSONAL INJURY OR DEATH. I HAVE TRAINED FOR THIS EVENT AND HAVE NO MEDICAL PROBLEMS. I KNOW MY ENTRY IN NON-REFUNDABLE NO MATTER WHAT THE REASON AND I WILL NOT ASK FOR IT BACK. THE DECISION OF THE RACE DIRECTOR IS FINAL.

__________________________________________________________________
Signature of Athlete Date (Signature of Parent or Guardian if under 18 years)


For more information call 360-480-5981 or wanttoduit@hotmail.com 



Site hosted by "ontherunevents.com" Your Online source for the Long Distance Running Community

Contact us today for details on how we can help get your event or product Online