STooPiD Run Entry Form

DATE OF BIRTH: m___/d___/y____   SEX: M__ F__

LAST NAME: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|

FIRST NAME: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|

STREET ADDRESS: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|

CITY: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__| STATE: |__|__|

ZIP: |__|__|__|__|__| PHONE#: (____)|__|__|__-__|__|__|__|

E-MAIL: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|

T-SHIRT SIZE: S___ M___ L___ XL___

OPTIONAL:

DINO SINGLET or SOCKS (not included with entry – see below) SIZE: S___ M___ L___ XL___

TEAM/SPONSOR: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|

OCCUPATION: _______________ STOOPID TIDBIT ABOUT YOURSELF: _____________________________

Total Paid: ____

 

PRICES per event

ITEM

Early*

Slacker**

Race Entry

$25

$35

DINO Singlet

(Pyro Apparel) - $25

DINO Socks

DeFeet Air-e-ator $5 --- DeFeet Woolie Boolie $10

*Early Registration must be received one week before the event (June 26).

**Slacker Registration is available from June 27 through race morning ending 7:59:59 am.

ALL RUNNERS MUST SIGN A LIABILITY RELEASE FORM AT THE RACE VENUE.

Mail entry with check payable to: DINO LLC, PO Box 36395, Indianapolis IN 46236

Or register online

For the most complete and updated (but stoopid) information: www.DINOseries.com

DINO Hotline (317)336-7553 e-mail Brian10@DINOseries.com