24 Hours of DINO Entry
Form 2010
ENTRY FEES per
person includes on-site camping, showers, t-shirt,
two meals, and more
24 Hr: $120… after Sept 3:
$125… race weekend: $130
12 Hr: $80 … after Sept 3: $85… race weekend: $90
6 Hr: $60 … after Sept 3: $65… race weekend: $70
USA Cycling one-day permit: add $5 per
person
(required of all riders who are not members of USA Cycling)
ALL RIDERS MUST
SIGN A LIABILITY RELEASE FORM AT THE RACE VENUE. No refunds after
September 3.
Mail entry with
check payable to: DINO
Or register online
at www.DINOseries.com/24
DIVISION (Circle one):
24-hour 1MA,
1WM, 2MA, 2CO, 2WM, 4MA, 4WM, 4CO, 4BG, 6MA, 6WM, 6CO, 6BG, SS
12-hour 1MA, 1WM, 2MA, 2CO, 2WM, 4MA, 4WM,
4CO, 4BG
6-hour 1MA, 1WM
NUMBER OF RIDERS ON
TEAM: __
Mail all team
members’ entry forms together. Enter the same team name in TEAM/SPONSOR blank
below.
If Annual: LICENSE#: |__|__|__|__|__|__|__|__| EXP. DATE: |__|__/__|__/__|__| AGE: _____ SEX: M__
F__
LAST NAME: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
FIRST NAME: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
STREET ADDRESS: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
CITY:
ZIP: |__|__|__|__|__| PHONE#: (____)|__|__|__-__|__|__|__|
E-MAIL: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
T-SHIRT SIZE:
S___ M___ L___ XL___
Extra Meals for Spectator(s) $10 each. Indicate quantity: Saturday___ Sunday___
Extra Camping for Spectator(s) $5 per night per person. Saturday___ Sunday___
EMERGENCY CONTACT
INFO:
NAME: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
PHONE#: (____)|__|__|__-__|__|__|__|
or SPECTATOR AT THE EVENT ___
OPTIONAL:
TEAM/SPONSOR: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
OCCUPATION: _______________ TIDBIT
ABOUT YOURSELF: _____________________________