WHICH DATE(S) ARE YOU REGISTERING FOR? ____
DINO PLATE#: |__|__|__|__| (Leave blank if you do not yet have
a “Kenda” numberplate)
USAC LICENSE# (leave blank if you are not a USA
Cycling member): |__|__|__|__|__|__|__|__| EXP.
DATE: |__|__/__|__/__|__|
WAVE (Circle
One): Pro/elite1, Cat1 Men, Cat2Open, Cat2 under 29, Cat2 30-34, Cat2
35-39, Cat2 40-49, Cat2 50+, Cat1 Women, Cat2 Women, Cat3 19-29, Cat3 30-39,
Cat3 40-49, Cat3 50+, Cat3Junior, Clydesdale, Cat3 Women, Intro
AGE: _____ SEX: M__ F__ CATEGORY: ____
LAST NAME: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
FIRST NAME: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
HAVE YOU ENTERED A DINO
MOUNTAIN BIKE IN THE PAST YEAR? No Yes – if yes you may leave lines below blank,
unless changed.
STREET ADDRESS: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
CITY:
ZIP: |__|__|__|__|__|
PHONE#: (____)|__|__|__-__|__|__|__|
E-MAIL: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
OPTIONAL:
SHIRT,
TEAM/SPONSOR: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
OCCUPATION: _______________ TIDBIT ABOUT
YOURSELF: _____________________________
|
CLASS |
early* |
day-of |
Season pass |
|
INTRO / JR |
$10 |
$15 |
$65 |
|
Cat3 / CLY |
$15 |
$20 |
$100 |
|
CAT2 |
$20 |
$25 |
$130 |
|
CAT1 |
$25 |
$30 |
$165 |
|
|
Add $5 if you are not a USA Cycling member |
Buy annual lic. ($60) Or add $5 per race |
|
|
T-SHIRT |
Add $10 |
Included! |
|
|
DINO |
$40 |
||
|
DINO SOCKS (by DeFeet) |
Air-e-ator $5 Woolie Boolie $10 |
||
TOTAL PAID: _____
DATE / CITY
1. May 1
2. June 6
3. June 19 French Lick IN
4. July 4
5. July 25
6. Aug 15
7. Aug 29
*Early Entry must be received by the Wednesday before the
event.
ALL RIDERS MUST SIGN A LIABILITY RELEASE FORM AT THE
RACE VENUE.
$5 NUMBERPLATE DEPOSIT will be required, refunded upon
return of number.
Mail entry with check payable to:
DINO, LLC;
Or register online at www.DINOseries.com