DINO Trail Run Series Entry Form 2006

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 11 Indianapolis, IN Eagle Creek Park

2. April 22 Avon, IN Washington Twp Park

3. June 3 Bloomington, IN Wapehani Park

4. July 1 North Vernon, IN Muscatatuck Park

5. Sept 9 Indianapolis, IN Town Run Trail

6. Oct 21 Indianapolis, IN SouthWestway Park

7. Nov 18 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

*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 Brian06@DINOseries.com