REGISTRATION FORM

First Name: ____________________ Middle:________ Last Name:________________

Gender: _____ Birthdate: __________ Age as of December 31, 2007____________

Email: (print clearly!) ____________________Contact #:( ___ ) _______ _____

Address:_______________________________________________________________

T-shirt size? _____________(S,M,L,XL)

Are you a USAT member? _______(Y/N) If yes, enter your USAT # here:____________

Will you compete as an Athena (women 150#+) or Clydesdale (men 200#+)? ___(Y/N)

RELAYS: Attach to this sheet the same information above for all relay team members.

Relay name: _____________________________

If you are not a USAT member, each individual or relay team member must pay $10 for a one-day license to race.

WHEN:	Early til May 23		Late 5/23 - 6/21		On Site 6/23
HOW:	Online	Mail	Online	Mail	Race
Individual	$50	$55	$55	$60	$65
Relay Team	$70	$75	$75	$80	$85

Individual $_____ or

Relay Team $_____

Individual one-day USAT license __ # x $10 = $_____

Make check payable to Tuscaloosa Triathletes $_____

Mail to:
Tuscaloosa Triathletes
PO Box 861442
Tuscaloosa, AL 35486-0013

All participants must sign a waiver at time of packet pick up.