| Official Entry Form Luna Bar All Women's Triathlon Festival Luna Triathlon and Duathlon Super Sprint Women's Triathlon and Duathlon Rancho Seco Park, Sacramento, 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 Relay | Age-Group Athena | ____________________________________ |
| Category: | Until July 1 | Until Race Day | On Race Day: |
| Luna Bar Triathlon |
$65 | $85 | $90 |
| Luna Bar Triathlon Relay Team | $100 | $100 | $120 |
| Luna Duathlon | $60 | $70 | $75 |
| Luna Duathlon Relay Team | $90 | $90 | $110 |
| Super Sprint Luna Tri/Du | $55 | $55 | $65 |
| Total Body Fitness 5209 Blaze CT. Rocklin, Ca 95677 |
Make checks payable to: TOTAL BODY FITNESS Total Amount Enclosed: $_____________ |