Entry Form |
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| Team name:___________________________________________ Preferred 4 digit race number: ___________ (first come, first served) Paddler One information Name_________________________________________________________ Male______ Female______ Age at Race Date_______ Shirt Size ______________ Street____________________________________ City______________________________________ State/Province_____________________________ Country___________________________________ Zip/Postal Code____________________________ Phone (w) ___________________________ (h)________________________ Fax___________________________ E-mail __________________________ I read the rules page at http://www.rivermiles.com/resources/race.html and I agree. _______ Paddler Two if applicable Name_________________________________________________________ Male______ Female______ Age at Race Date_______ Shirt Size ______________ Street____________________________________ City______________________________________ State/Province_____________________________ Country___________________________________ Zip/Postal Code____________________________ Phone (w) ___________________________ (h)________________________ Fax___________________________ E-mail __________________________ I read the rules page at http://www.rivermiles.com/resources/race.html and I agree. _______ Payment: Check one of the following options.If paying online, you must still print and submit this form and waivers. Tandem Payments: We have entered a Tandem Category. Enclosed is our team check of $180 dollars.______ (we paid our tandem fee via PayPal by clicking the link)______ ________________________________________________________________________________ Solo Payments: I have entered a Solo Category. Enclosed is my check for $100 dollars.______ (I paid my solo fee by clicking the PayPal link) ______ Make checks payable to Rivermiles, LLC Deadline for applications is July 1, 2007. Team subs are permitted up to the pre-race meeting on July 23, 2007. Mail with signed waiver(s) to: Rivermiles, LLC 16047 S. Avalon Olathe, Ks. 66062 E-mail:  Website: www.rivermiles.com Phone: 913-244-4666 |
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