Arrowhead DATB Triathlon
Oct 12, 2008
Field limit 1000
2008
Entry Form
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(Relay Team Only)
Send in 3 copies
Indicate team member
and team name below: |
[_] Swimmer
[_] Biker
[_] Runner |
_____________________
Team Name |
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MESP
use only)
Fee: $_________
[_] Cash
[_] Check #__________ |
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(MESP use only)
___________
BIB#
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| Last:________________________ First:_____________________ |
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| Address:_________________________________________________ |
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| City:__________________________ ST:______ ZIP:___________ |
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| DOB (mm/dd/yy):___ /___ /____ Age On Race Day: _______ |
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| Sex:[M]/[F]
Telephone No.:(_____)_____-_________ |
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| email:_____________________________________________ |
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| Occupation:____________________________________ |
| USAT#:____________________________________ |
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Select A Division |
| [_] |
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Individual Age Group |
| [_] |
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Relay Team (use 3 forms) |
| [_] |
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Greg Lucia Thunderthighs - Men 185-199 pounds |
| [_] |
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Clydesdale - Men 200-224 pounds |
| [_] |
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Clydesdale - Men 225+ pounds |
| [_] |
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Athena - Women 150+ pounds |
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[_]
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Mountain
Bike
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| Race Fee |
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Ind |
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Relay
Team |
| [_] |
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Regular: |
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$95 |
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$135 |
| [_] |
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Late: |
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Hermosa : After August 31, 2008 |
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$105 |
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$145 |
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$___________ |
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Non-USA
Triathlon members: Add $10 per event for a race-day USAT membership.
Relays add $10 per non-USAT team. |
$___________ |
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Total
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$___________ |
Mail and make non-refundable check payable to:
MESP, 29395 Agoura Rd.,Suite 102, Agoura Hills, CA 91301 |
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