| Official Entry Form Granite Bay Duathlon & Super Sprint Duathlon 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: | Division: | Relay Team Name: | ||
| Individual | Age-Group | |||
| Relay | Male Female Co-Ed | ____________________________________ |
| Category: | Until Race day | Race Day: | |
| Individual | $55 | $65 | |
| Super Sprint | $50 | $60 | |
| Both Duathlons | $75 | $100 | |
| Relay Team for GB Duathlon | $90 | $110 |
| Total Body Fitness 5209 Blaze CT. Rocklin, Ca 95677 |
Make checks payable to: TOTAL BODY FITNESS Total Amount Enclosed: $_____________ |