2008 Pigman Triathlon Official Entry Form (3/04/2008)

Division (select Rone) INDIVIDUAL - £ Age-grouper £ Elite £ Clydesdale/Athena OR TEAM - £ Male £ Female £ Coed

Name__________________________________________

Birthday________

Sex_________

First

Last

MM/DD/YY

M/F

Address______________________________________________________________________________

Street

City

State

Zip

Phone_________________________

Email Address________________________________________

T-shirt (circle one)

S

M

L

XL

XXL

USA Triathlon#_________________

Club Name (If applicable. Club name must be identical for all members. ) ___________________________________

ADDITIONAL TEAM INFORMATION

Team Name________________________________________________________________________

Swim Name______________

Bike Name_____________

Run Name______________________

Swim Shirt ______________

Bike Shirt _____________

Run Shirt ______________________

Swim USAT # ____________

Bike USAT # ___________

Run USAT# ____________________

NOTE: USAT members entry fee $10 less

USAT Age

Individual Entry Fee

Team Entry Fee

SPRINT IS FULL Sprint – postmarked by March 1^st

______

$60_________

$114 __________

Sprint – postmarked March 2^nd to April 19^th

______

$70_________

$129 __________

Sprint – After April 19^th

______

$85_________

$141__________

Upgrade Sprint Cotton shirt for moisture management technical shirt (NOTE: Long Course entry fee includes technical shirt)

$5_________

$15_________

Long Course - postmarked by March 1^st

______

$85_________

$150 _________

Long Course - postmarked March 2^nd to June 1^st

______

$100_________

$165 _________

Long Course - After June 1^st

______

$115_________

$177 _________

Total Enclosed

_________________________________

Each entrant must sign official Pigman Triathlon Waiver at packet pickup.

Please make checks payable to: Pigman Triathlon

Mail to: P.O. Box 582 Marion, Iowa 52302

Phone: (319) 373-0741