kids` triathlon - Decatur Swim Club

KIDS’ TRIATHLON
Sunday, April 22, 2012
*Swim: 100 yds in water 5’ or less deep *Bike: 2.3 Miles around Wyman Park
*Run: 1 Mile in Wyman Park
Must be between the ages of 5 & 13 on race day!
LOCATION: Sullivan Civic Center, 600 N. Washington, Sullivan, IL
*Packet Pick Up: 7:30 – 8:30 * Race starts at 9:00 a.m. *
EVERY athlete will get a nice medal and t-shirt!
Email tayjay06@yahoo.com Register at https://dolphins.proeventreg.com/kids2012
$20 Before April 1st
$25 After April 1st
Huge Thanks to our sponsors:
Cater-Vend of Mattoon & McGrady Stables
Chip timing donated by Champion Chip!
Complete the following form and mail it and payment to Pennie Zollmann 756 CR 1000 E Sullivan, IL 61951
_________________________________________________________________________________________________________________
Sullivan Blue Dolphins Kids’ Triathlon Form (Please Print Clearly)
First Name:___________________________________________
Last Name:_______________________________________________
Address: _____________________________________________
City, State, Zip:____________________________________________
Birth Date:_______________________M or
F
Parent or Guardian: _________________________________________
T-Shirt Size:
M
M
Adult:
Youth:
XL
XL
L
L
S
S
Parent/Guardian Phone:______________________________________
I hereby absolve Sullivan Blue Dolphins as well as the Sullivan Civic Center and any of it’s members, helpers or sponsors of all liability from any injury
resulting from this event.
_____________________________________________________
Parent or Guardian Signature
________________________________
Date