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Saturday, June 25, 2011 -- Clay, WV
Elk River Challenge Triathlon ENTRY FORM (iPO Event Id#: 13478)

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RACE CONTACT: William Dunn (phone) 304-587-4455 (e-mail) welldunn44@suddenlink.net

Fee: . . . Team fee $90.00 . . . Solo fee $30.00

Includes registration, t-shirt and BBQ dinner! Pre-Registration Must be post marked by June 20, 2011

Make checks payable to: Elk River Challenge

Mail to: Elk River Challenge, 2730 Fola Road, Bickmore, WV 25019

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SOLO CATEGORY

Choose Solo Type: Mens____ or Womens____

Print name and information here if racing solo.

Name ______________________________________________________________________

Address___________________________________________________________________

City____________________________________________State_______ Zip__________

T-shirt Size: Small____Medium____Large____XL____XXL____

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OR
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TEAM CATEGORY

Types are men only, women only, and co-ed (must have at least one female).

Choose Team Type: Mens____ Womens_____ Co-ed____

TEAM NAME: ____________________________________________________________________

Print team member names and information below if racing as a team.

  • TEAM MEMBER #1 __________________________________________________________________

    Address___________________________________________________________________

    City____________________________________________State_______ Zip__________

    T-shirt Size: Small____Medium____Large____XL____XXL____

  • TEAM MEMBER #2 __________________________________________________________________

    Address___________________________________________________________________

    City____________________________________________State_______ Zip__________

    T-shirt Size: Small____Medium____Large____XL____XXL____

  • TEAM MEMBER #3 __________________________________________________________________

    Address___________________________________________________________________

    City____________________________________________State_______ Zip__________

    T-shirt Size: Small____Medium____Large____XL____XXL____