Lowell Monster Dash Duathlon
October 26, 2008
Hosted by: The Lowell Elks
Proceeds going to: Lowell Elks Charity of Choice

Run 3 miles ~~ Bike 14.5 miles ~~  Run 3 miles

On line registration www.active.com

Race Director: ccloutiertri@aol.com

Registration Form

Name:_________________________________

Street: _________________________________

City/State/Zip: _________________________

Email: _________________________________

Age:______Sex: _______ D.O.B____________

Home ph#______________________________

Team Name: ___________________________

Run: __________________________________

Bike:__________________________________

Run: __________________________________
 
Race Fees   Teams can be 2 or 3 people
Single (Oct. 27, 2008) $45
Single (Day of) $50
Team (Oct. 27, 2008) $60
Team (Day of ) $70

NO REFUNDS

Long Sleeve T-shirts to those who register before
Oct. 20th: Size_____

Amount Paid:  $_____________________

Checks Payable to: DoubleCRacing

Mail: Attn: Claire Cloutier

3 Dickens Lane, Tyngsboro, Ma  01879

Please read waiver before signing:

In consideration of this entry being accepted, I herby for myself, my heirs, executors, and administrators waive any and all rights and claims for damages I may have against the Lowell Elks, Staff, contributors, organizers, and all sponsors of this event.

Athlete’s signature:

_____________________________________________________

Team Member signautres:

________________________________________

Signature of parent/guardian (if under 18 years old)