| Official Entry Form September Super Sprint 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 | Male Female Co-Ed | ______________________________ | ||
| _____________________________________ | ||||
| Until Race Day | On Race Day: | ||
| Super Sprint Triathlon | $60 | $70 | |
| Super Sprint Triathlon: Relay | $90 | $120 | |
| Super Sprint Duathlon: Individual | $55 | $65 | |
| Super Sprint Duathlon: Relay | $80 | $110 | |
| Total Body Fitness 5209 Blaze CT. Rocklin, Ca 95677 |
Make checks payable to: TOTAL BODY FITNESS Total Amount Enclosed: $_____________ |