Registration Fee: 
Adult: $190.00 ____________ 
Youth: 4-12 yrs. $75.00____________ 
Child: 0-3 yrs. $Free 
T-Shirt: 
S M L X-L XX-L XXXX-L 
Quantity Amount Adults:$20.00 
S M L 
Quantity Amount Youth:$15.00  
PLEASE PRINT CLEARLY: 
NAME ______________________________________
ADDRESS_______________________________________________ 
CITY, 
STATE, ZIP______________________________________________________________ TELEPHONE NUMBER_________________________ 
EMAIL __________________________