ADULT REGISTRATION FORM

October 9, 2010
Scout Island
Fresno, California

Completed registration is required for teams to participate

Check-In and race times will be sent to coach upon final approval

Coach Name: T-Shirt Size:

Business/Organization:

Address:

City, Zip Code: Fax:

E-Mail Address: Phone:

Participant Name Age Gender T-Shirt Size

□ Participation Agreement Form (to be handed in before start of race )

□ There is a $100.00 Fee per team to handed in before the start of the race.

Coach's Signature Date

Please send completed registration form(s) to:

Aleiba Moreno
Safe and Healthy Kids Department ● Fresno County Office of Education
1111 Van Ness ● Fresno, CA 93721
Or fax to: (559) 497-3704

For event information please contact at:

(559) 265-3002 ●amoreno@fcoe.org

REGISTRATION DEADLINE: SEPTEMBER 24, 2010