Entry Form
Thanksgiving Dash Half-marathon, 10 Miles, 10K, 5K & 1 mile & Duathlon - November 18, 2006
Mail completed entry form and fee to: Thanksgiving Dash Half-marathon, 10 Miles, 10K, 5K & 1 mile & Duathlon, @ Kristina Salazar 9435 180th Way Sw, Rochester, WA 98579, Olympia, 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):

Half-marathon  (Before October 16)        $30.00  $ ______
Half-marathon  (Before October 29)        $32.00  $ ______
Half-marathon  (Before November 10)       $35.00  $ ______
Half-marathon  (Before November 18)       $40.00  $ ______
Half-marathon  Day of race                $45.00  $ ______
10 Miles       (Before November 1)        $25.00  $ ______
10 Miles       (Before November 18)       $30.00  $ ______
10 Miles       Day of race                $35.00  $ ______
10K (6.2 miles) (Before October 16)       $20.00  $ ______
10K             (Before October 29)       $22.00  $ ______
10K             (Before November 18)      $25.00  $ ______
10K            Day of race                $30.00  $ ______
5K (3.1 miles)  (Before October 16)       $18.00  $ ______
5K              (Before October 29)       $20.00  $ ______
5K              (Before November 18)      $23.00  $ ______
5K             Day of race                $25.00  $ ______
1 mile          (Before November 18)      $11.00  $ ______
1 mile         Day of race                $15.00  $ ______
Duathlon        (Before November 1)       $25.00  $ ______
Duathlon        (Before November 18)      $30.00  $ ______
Duathlon       Day of race                $35.00  $ ______
2/3 person team Duathlon (Before Nov. 18) $35.00  $ ______
2/3 person team Duathlon Day of race      $40.00  $ ______
                      No shirt option      -$5.00 $ ______
            Upgrade to longsleeve shirt    $7.00  $ ______
            Upgrade to long sweatshirt    $12.00  $ ______
            Extra short sleeve shirt       $7.00  $ ______
            Extra longsleeve shirt        $12.00  $ ______
            Extra long sweatshirt         $18.00  $ ______

T-shirt Size (circle one): 
Adult S  M  L  XL               XXL  ADD   $3.00  $ ______
TOTAL ENCLOSED                                    $ ______

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

Waiver I HEREBY RELEASE THE PUGET SOUND CRUISERS, MILLERSLYVANIA STATE PARK, THURSTON COUNTY, CITY OF MAYTOWN, STATE OF WASHINGTON, EMPLOYEES, VOLUNTEERS, AND ANYONE ELSE INVOLVED IN THE ABOVE EVENTS. I KNOW BY SIGNING THIS FORM, THAT I'M WAIVING MY RIGHTS TO SUE FOR ANY A ND ALL REASONS, INCULDING BUT NOT LIMITED TO PERSON INJURY OR DEATH. I HAVE TRAINED FOR THIS EVENT AND HAVE NO MEDICAL PROBLEMS. I KNOW MY ENTRY FORM IS NONREFUNDABLE 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 360-273-9684 or wanttoduit@hotmail.com

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