KURURAU KRUSHER
28 February 2009
ENTRY FORM
Fill in details below, print and mail with entry fee to PO Box 5, Taumarunui
before February 22, 2009.

Stages: Bike 44k, Run 16k, Kayak 22k, MTB 26k (Total 110k)

Category [select category]

Individual Men (min age 16)	Veteran Men (40+)	Men's Team	Corporate Team
Individual Woman (min age 16)	Veteran Woman (35+)	Woman's Team	Mixed Team
Veteran Team	Two Person	Secondary School         (12-19, must attend the same school)

Team Name

Individual/Team Captain

First Name
Surname
Street     Address

Suburb

City

Phone

Email

Personl  Profile
TICK	Cycle  Run  Kayak  MTB	Age:

Team Member No 2

First Name
Surname
Street  Address

Suburb

City

Phone

Email

Personal Profile
TICK	Cycle    Run    Kayak    MTB	Age

Team Member No 3

First Name
Surname
Street Address

Suburb

City

Phone

Email

Personal Profile
TICK	Cycle    Run    Kayak    MTB	Age

Team Member No 4

First Name
Surname
Street Address

Suburb

City

Phone

Email