| MMLF Registration Form - Sammamish Splash Kids Tri 8/22/2010 |
| Please enter all the information for a valid registration |
| Name |
| Address |
| City | State | Zip |
| Gender Male | Female |
| Phone | Age on 12/31/2010 |
| Mobile | Date of Birth |
| Emergency Contact | Phone |
| All participants must sign the race class waiver at packet pickup. No transfers no refunds. |
| Event Name: Sammamish Splash Kids Tri 8/22/2010 | ||
| I will be participating in the following category: | ||
| Price increases $10 on 8/8, $15 on 8/17, race day registration cash or check only - no credit card onsite |
| Kids (5 to 15) $30 $45 | |||
| 5-7 | 8-10 | 11-13 | 14-15 |
| The USAT fee must be paid for EACH participant who is not a USAT member. USAT numbers are NOT transferable and are valid ONLY for the individual member. |
| 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 younger. I am including the membership fee (good for a year) of $5. |
| A logistics email will be sent the week of the race. Parents must bring picture ID (no ID, no packet). You cannot pick up for someone else's child. |
| 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. |