SMARTBLAST REGISTRATION

June 19, 2010 - Depot Park - Clarkston , Michigan

There are two ways to register for the race:

Credit Card Registration (signmeup): https://www.signmeup.com/69062

Mail in Registration: Complete the form below and print it out. Make the check payable to Marcia Harrington. Mail this form and your check to SMARTBlast LLC, 3200 Schoolhouse, Waterford, MI 48329.

Team Name:
Division:
Team Captain Name: Age: Sex:
Address: Phone:
City: State: Zip: Shirt Size:
E-mail Address:
Teammate Name Age: Sex:
Teammate Shirt Size:
Teammate E-mail Address: Phone:
Team Entry Fee: * $70.00 Per Person
Will you be renting a canoe for this race?
*Canoe rental arrangements must be made through Heavener’s Canoe Rental
How did you learn about the race? :

***PRINT THIS FORM AND MAIL IT IN WITH YOUR CHECK ***

Make Check Payable to Marcia Harrington

Mail to: SMARTBlast LLC, 3200 Schoolhouse, Waterford, MI 48329.

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