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MDA/Chadwick Challenge Biathlon Entry Form

Please Print down, Fill Out and Send in with your Check

Name (print)__________________________________________

Age ____(as of July 9, 2000) (You must be at least 14 to enter)

Entrants signature _____________________________________

(Parent/Guardian Signature)_______________________________
(if Entrant is under 18 yrs.)

Sex            

Shirt Size (Adult) Lg. X-Lg.

Street                                                      

City                           

State                           

Zip_________

Mail to:

ERA Larson Real Estate
8 Park Place
Fredonia, NY 14063

$25 per entry - Checks payable to: MDA/Chadwick Challenge.

ENTRY FEE

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Entry fee is $25.00.

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Canadian money received at par.

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Registration fees are non-refundable.

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Goody bags include shirt, water bottle, etc.

 
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