Entry Form
Octoberfest Triathlon/Duathlon/Kids mini-tri & footraces - Saturday October 13, 2007
Mail completed entry form and fee to: Octoberfest Triathlon/Duathlon/Kids mini-tri & footraces, @ 9435 180th Way Sw, Rochester, WA 98579, Elma, WA
(Please print)

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

FEES: (Entries include T-shirt):

Triathlon (Before September 23)          $40.00  $ ______
Triathlon (Before Oct. 1 )               $45.00  $ ______
Triathlon (Before Oct. 13)               $50.00  $ ______
Triathlon Day of race                    $55.00  $ ______
TRI 2/3 person team (Before Oct. 13)     $70.00  $ ______
Duathlon (Before Oct. 1)                 $35.00  $ ______
Duathlon (Before Oct. 13)                $40.00  $ ______
Duathlon  Day of race                    $45.00  $ ______
DU 2/3 person team (Before Oct. 13)      $50.00  $ ______
DU 2/3 person team Day of race           $60.00  $ ______
Kids mini-tri (Before Oct. 13)           $18.00  $ ______
Kids mini-tri day of race                $22.00  $ ______
6 mile run (Before Oct. 1)               $20.00  $ ______
6 mile run (Before Oct. 13)              $25.00  $ ______
6 mile run day of race                   $30.00  $ ______
3 mile run (Before Oct. 1)               $18.00  $ ______
3 mile run (Before Oct. 13)              $20.00  $ ______
3 mile run day of race                   $25.00  $ ______
1 mile run (Before Oct. 13)              $15.00  $ ______
1 mile run day of race                   $18.00  $ ______
                     No t-shirt option   -$5.00  $ ______
               Extra short sleeve shirt   $7.00  $ ______
               Extra tank top            $10.00  $ ______
               Extra long sleeve shirt   $12.00  $ ______
               Extra sweatshirt          $18.00  $ ______
               Upgrade to tank top        $7.00  $ ______
               Upgrade to long sleeve     $7.00  $ ______
               Upgrade to sweatshirt     $12.00  $ ______  

T-shirt Size (circle one): 
Adult S  M  L  XL               XXL ADD   $4.00  $ ______
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, VANCE CREEK PARK, CITY OF ELMA, GRAYS HARBOR COUNTY, STATE OF WASHINGTON AND ANY ONE ELSE INVOLDED, INCLUDING ANY VOLUNTEERS, SPECTATORS, EMPLOYEES OR ANY ONE ELSE IN THE ABOVE EVENTS. I KNOW BY SIGNING THIS FORM I AM WAIVI NG MY RIGHT TO SUE FOR ANY AND ALL REASONS, INCLUDING BUT NOT LIMITED TO PERSONAL INJURY OR DEATH. I HAVE TRAINED FOR THIS EVENT AND I HAVE NO MEDICAL PROBLEMS. I ALSO KNOW MY ENTRY FEE IS NON-REFUNDABLE NO MATTER WHAT THE REASON AND I WILL NOT ASK FOR IT BACK. THE DECISION OF THE RACE DIRECTOR I S 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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