West Union Triathlon - Registration Form

Click here to register online before Thursday, June 26, 2014.

You may also print and mail the form below. Form must be received my Thursday, June 26. 2014.

Individual/Runner Name Male Female Age

Street Address Birthdate

City State Zip

Signature Email

Team Name if applicable

Biker's Name Male Female Age

Street Address Birthdate

City State Zip

Signature Email

Swimmer's Name Male Female Age

Street Address Birthdate

City State Zip

Signature Email

Shirts are Adult Sizes, S , M , L , XL , XXL

If this is a team registration, please indicate the number of each size needed.

FEES:

  • $30 Student (9-17 years)
  • $35 Individual (18+ years)
  • $60 Team

Make Checks payable to: West Union Park and Recreation

To ensure a t-shirt on race day, forms must be received by June 1, 2014.

Print this page and mail with check to:

  • West Union Park and Recreation
  • West Union Triathlon
  • PO Box 151
  • West Union IA 52175

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