| Official Entry Form 2010 Granite Bay Half Marathon Saturday, October 23, 9am start 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 60-69 70+ |
| Category: | Early bird | After Oct. 1 | On Race Day: | |||||||
| Half Marathon Individual | $35 | $45 | $55 | |||||||
| 5k Individual | $25 |
$25 (Race Week special) |
$40 |
| Total Body Fitness 5209 Blaze CT. Rocklin, Ca 95677 |
Make checks payable to: TOTAL BODY FITNESS Total Amount Enclosed: $_____________ |