2005 Flint Creek Sprint Triathlon Registration Form



Name_____________________________    Gender:    M    F       Age:______

                                                                                               Clydesdale     


Address__________________________________ City_________________

State___________________   Zip___________   Phone_________________

Email ______________________________________   T-shirt size:   M     L


Mail to:  Tri Mississippi, c/o Michelle Ridder, 1745 White Oaks Road, Campbell, CA  95008
Registration fee:  $55                        make checks payable to Tri Mississippi

$5 discount for active military
or register at ACTIVE


Early Registration Special!!!

Register by 8/26/05 and save 10%
(mail in registration only)

Registration fee:  $49.50