| Official Entry Form 2008 ICE Breaker Triathlon Sunday, April 13, 9am start 1/2 mile swim - 13 mile road bike - 4 mile run Baby Ice Breaker Triathlon 200 yard swim - 6.5 mile road bike - 2 mile run 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 Athena/Clydesdale | |||
| Relay | Male Female Co-Ed | ____________________________________ |
| Category: | Early: | Race Day: | |
| Individual | $70 | $80 | |
| Early bird (before Dec. 1) | $60 | ||
| Relay | $120 | $140 | |
| Baby ICE Breaker Triathlon | $55 | $65 | |
| Total Body Fitness 5209 Blaze CT. Rocklin, Ca 95677 |
Make checks payable to: TOTAL BODY FITNESS Total Amount Enclosed: $_____________ |