Entry Form
Mother's Day Triathlon/Duathlon, Kids Mini-tri & Footraces - May 10, 2008
Mail completed entry form and fee to: Mother's Day Triathlon/Duathlon, Kids Mini-tri & Footraces, @ 9435 180th Way Sw, Rochester, WA 98579, Elma, WA
(Please print)

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

FEES: (Entries include T-shirt):

Triathlon  (Before April 23)            $45.00  $ ______
Triathlon  (Before May 1)               $47.00  $ ______
Triathlon  (Before May 10)              $50.00  $ ______
Triathlon day of race                   $55.00  $ ______
2/3 person TRI team (Before May 10)     $60.00  $ ______
2/3 person TRI team day of race         $70.00  $ ______
Duathlon   (Before May 1)               $35.00  $ ______
Duathlon  day of race                   $40.00  $ ______
2/3 person Du team (Before May 10)      $50.00  $ ______
Kids mini-tri day  (Before May 10)      $18.00  $ ______
Kids mini-tri day of race               $20.00  4 ______
15K (9.3 miles) (Before May 10)         $25.00  $ ______
15K day of race                         $30.00  $ ______
10K (6.2 miles) (Before May 10)         $25.00  $ ______
10K day of race                         $30.00  $ ______
5K (3.1 miles)  (Before May 10)         $20.00  $ ______
5K day of race                          $25.00  $ ______
1 mile day of race                      $15.00  $ ______
kids dash 1/4 to 1/2 mile               $15.00  $ ______
               No t-shirt option        -$5.00  $ ______
            Extra short sleeve shirt     $7.00  $ ______
            Upgrade to tank top         $10.00  $ ______
            Upgrade to longsleeve       $13.00  $ ______
T-shirt Size (circle one): 
Adult S  M  L  XL   XXL
Child S  M  L  XL   

TOTAL ENCLOSED                                  $ ______

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

Waiver I HEREBY RELEASE THE PUGET SOUND CRUISERS, CITY OF ELMA, STATE OF WASHINGTON, COUNTY OF GRAYS HARBOR AND VANCE CREEK PARK, ALSO ANY VOLUNTEERS, EMPLOYESS OR ANYONE ELSE INVOLVED IN THE ABOVE EVENTS. I KNOW I WAIVING MY RIGHTS TO SUE BY SIGNING THIS FORM FOR ANY AND ALL REASONS, INCLUDING BUT NOT LIMITED TO PERSONAL INJURY OR DEATH. I HAVE NO MEDICAL PROBLEMS AND I KNOW THE RISKS INVOLVED IN A EVENT OF THIS TYPE. I ALSO KNOW MY ENTRY FEE IS NON-REFUNDABLE NO MATTER WHAT THE REASON AND 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 360-273-9684 or wanttoduit@hotmail.com

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