DINO Trail Run Series Entry Form 2005

WHICH DATE(S) ARE YOU REGISTERING FOR? ____

DISTANCE: 5k___ 15k___

AGE: _____ SEX: M__ F__

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

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

HAVE YOU ENTERED A DINO TRAIL RUN IN THE PAST YEAR? No Yes – if yes you may leave lines below blank, unless changed.

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

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

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

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

SHIRT, SINGLET, or JACKET (not included with entry – see below) SIZE: S___ M___ L___ XL___

OPTIONAL:

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

OCCUPATION: _______________ TIDBIT ABOUT YOURSELF: _____________________________

Total Paid: ____

EVENT# / DATE / CITY / VENUE

1. March 12 Indianapolis, IN Eagle Creek Park

2. April 16 Avon, IN Washington Twp Park

3. June 4 Indianapolis, IN Town Run Trail Park

4. July 2 North Vernon, IN Muscatatuck Park

5. Aug 20 New Castle, IN Westwood Park

6. Oct 29 Indianapolis, IN SouthWestway Park

7. Nov 12 Indianapolis, IN SouthEastway Park

PRICES per event

ITEM	Early*		Day-of	Season Pass
5k	$12		$15	$80
15k	$17		$20	$110
Shirt	Add $10			included
Singlet		(Pyro Apparel DINO Singlet) - $25 size: S M L XL XXL
Jacket		(Pyro Apparel DINO Jacket) - $50 size: S M L XL XXL

*Early Registration must be received by the Wednesday before the event.

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 at www.active.com

For the most complete and updated information: www.DINOseries.com

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