Early Athlete Entry

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$80.00

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First Name

Last Name *

Address( Address, City, State, Zipcode

Phone Number

Email

Birthday

Gender Select all that apply Male Female

Personal Best

Club Name, or unattached

Tshirt Size Select all that apply Small Medium Large Xlarge XXlarge

Raffle ticket purchase Select all that apply buy 1 raffle ticket (+ $5.00) Buy 2 raffle tickets, get one free (+ $10.00)

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