| Official Entry Form 50-mile Mountain Bike Challenge Solo, 2 or 4 person relay MTB ride Granite Beach, Folsom Lake, Granite Bay, CA |
| Last Name: | ______________________ | Street Address: | ___________________________________ | |||
| First Name: | ______________________ | City, State ZIP: | ___________________________________ | |||
| Gender: | Male Female | Phone: | ___________________________________ | |||
| Date of Birth: | ______________________ | Email: | ___________________________________ | |||
| Race Day Age: | ______________________ | Team/Club: | ___________________________________ |
| Category: |
19 and under
20-29
30-39
40-49
50-59
60+ |
| Category: | Before Race Day | On Race Day: | |||||
| Individual | $60 | $70 | |||||
| 2-Person Relay Team | $100 | $120 | |||||
| 4-Person Relay Team | $200 | $240 |
| Total Body Fitness 5209 Blaze CT. Rocklin, Ca 95677 |
Make checks payable to: TOTAL BODY FITNESS Total Amount Enclosed: $_____________ |