| MMLF Registration Form - September 8, 2012 Cottage Lake Tri |
| Please enter all the information for a valid registration |
| Name |
| Address |
| City | State | Zip |
| Gender Male | Female |
| Phone | Age on 12/31/2012 |
| Mobile | Date of Birth |
| Emergency Contact | Phone |
| All participants must sign the race class waiver at packet pickup. No transfers no refunds. |
| Event Name: September 8, 2012 Cottage Lake Tri | Adult Tri | Kids Tri |
| I will be participating in the following category: |
|
Race day registration cash or check only no credit card onsite |
| MUST ADD $12 USAT FEE IF NOT A MEMBER |
| All Prices Include Sales Tax - Price increases $10 on 8/29, $15 on 9/5 |
| Elite1 $104 | Friends and Family2 $72 | Kids (5 to 13) $33 |
| Age Group $72 | Clydesdale or Athena $72 |
| Relay (2 people, complete a form & pay USAT fee for each participant) $104 |
| Relay (3 people, complete a form & pay USAT fee for each participant) $143 |
| Relay Team Name |
| USA Triathlon Membership Number |
| You must have a valid membership card at packet pickup or pay the one-day fee for non-members. Join at www.usatriathlon.org |
| I am not a member of USA Triathlon and am 18 or older. I am including the one-day membership fee of $12. |
| I am not a member of USA Triathlon and am 17 or younger. I am including a one day membership fee of $10. |
| Check payable to: | Mary Meyer Life Fitness or MMLF | ||
| Total Payment Included: | T-Shirt Size | 2917 24th Ave W | |
| Seattle, WA 98199 |
| Questions? | Email Mary at MaryMeyerLifeFitness.com or call 206/282.3959 or visit www.MaryMeyerLifeFitness.com |
| How did you hear about us? |
| USAT rules enforced. This includes wearing a helmet at all times when on your bike. |
| Mandatory pre-race packet pickup the night before the race. A logistics email will be sent the week of the race. You can also go to event details on the web. You must bring picture ID (no ID, no packet). You cannot pick up for someone else. |
| 1Elite: complete two super sprint tris consecutively a unique challenge that almost anyone can achieve! (swim/bike/run/swim/bike/run) |
| 2Please provide Friends and Family names, so you can race together: |