| Official Entry Form. CLIF BAR Team Challenge Triathlon .75 mile swim - 14 mile road bike - 5 mile run Granite Beach, Folsom Lake, Granite Bay, CA Saturday September 24, 2011 Please note: Each Team participant must fill out an entry form. |
| Last Name: | ______________________ | Street Address: | ___________________________________ | |||
| First Name: | ______________________ | City, State ZIP: | ___________________________________ | |||
| Gender: | Male Female | Phone: | ___________________________________ | |||
| Date of Birth: | ______________________ | Email: | ___________________________________ | |||
| Race Day Age: | ______________________ | Team/Club: | ___________________________________ |
| Category: | Relay Team Name: | |
Male Female Co-Ed Corporate Family
Police and firefighters |
____________________________________ |
| Category: | All prices are PER TEAM | |
| Until April 1 | $120 | |
| Until Race Day | $140 | |
| Race Day | $160 | |
| Total Body Fitness 5209 Blaze CT. Rocklin, Ca 95677 |
Make checks payable to: TOTAL BODY FITNESS Total Amount Enclosed: $_____________ |