DU @ THE DAM DUATHLON
REGISTRATION FORM

SATURDAY, JUNE 26, 2010

___Age Group  ___Elite ___Clydesdale/Athena ___Team Coed ___Team Men ___Team Women
(Athena - women 160+ lbs | clydesdale- 200+ pounds | Age group -most choose this option) 

Last Name                       First Name                                Age on    Sex  

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                                                                         race day    M/F
Mailing address (include apt. # and c/o)                    

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City and State                                                       Zip/Postal Code

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Birth date      Area Code       Telephone                          

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 Mo  Day Yr   

E-Mail Address 

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Shirt Size 	Small |__|  Medium |__|   Large |__|    X Large |__|   

TEAM

(Biker)Last Name                       First Name                                Age on    Sex  

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Mailing address (include apt. # and c/o)                    

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City and State                                                       Zip/Postal Code

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Birth date      Area Code       Telephone                          

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 Mo  Day Yr   
E-Mail Address 

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Shirt Size 	Small |__|  Medium |__|   Large |__|    X Large |__| Last Name                      
 
(Runner #2)First Name                                Age on    Sex  

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Mailing address (include apt. # and c/o)                    

City and State                                                       Zip/Postal Code

|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|   |__|__|__|__|__|__|
Birth date      Area Code       Telephone                          

|___|___|___|  |__|__|__| |__|__|__|-|__|__|__|__|   
 Mo  Day Yr   

E-Mail Address 
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Shirt Size 	Small |__|  Medium |__|   Large |__|    X Large |__|     

                              

WAIVER. Knowingly and at my own risk I do hereby apply to enter an athletic
contest.  I hereby agree that I release and discharge Vacation Sports, and all other parties associated with Du @ the Dam Duathlon from all claims, demands, injuries, damages, actions or causes of action from all acts of active or passive negligence on the part of
such corporations, organizations, clubs, their servants, agents or employees, and hereby assume all the risks associated with my participation in the event.  Further, I hereby grant full permission to any and all of the foregoing to use my name, likeness and voice, as well as any photographs, videotape, motion pictures, recordings and any other record of this event in which I may appear for any legitimate purpose
including broadcast of the event, the reuse in any media of this broadcast and in advertising and promotion.

Signature
(by parent or guardian if
participant is under 18) ___________________________________________________

NO REFUNDS

MAIL ENTRY FORM WITH ENTRY FEE TO

Du @ the Dam Duathlon
Vacation Sports
1665 9th Street
White Bear Lake, MN 55110

Make check payable to Vacation Sports

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