Race Time: Proceeds will benefit the 2016 Burbank YMCA Annual Fund which provides scholarships to children and families so they can participate in YMCA programs. ENTRY FEE: $35 suggested individual fee $50 suggested team fee

RACE SETUP: Complete a 800 yard pool swim (32 lengths/16 laps), 12.5 miles stationary bike ride and a 3 mile treadmill run. 1st heat will start at 1pm. Prizes will be awarded to the top male and female finisher.

CHECK-IN (receive your heat assignment)  

Fri, April 1, 5-7pm Sun, April 3, 12:30pm

Mail Form & Entry Fee To: BURBANK YMCA Attn: Amy Vendt 36 Arthur B. Lord Dr. Reading, MA 01867

Name

Sex

Age on race day

Address Email Address

Phone Payment:

check

card on file: _______________ (last 4 digits)

Waiver: In consideration of my being accepted, I hereby waive any and all rights and claims for damages I may have against the Burbank

YMCA, Event Directors, Volunteers and Sponsors for any and all injuries incurred by me at the said event. Signature

Date

Signature of Parent of Guardian if under 18

Date