Olympic Relay - Captain Information

Name *
Gender *
      
Birth Date *
    

Age as of December 31st of race year:

Age on Dec 31 *
Address *
Email *
Phone *
T-Shirt Size *
                                    

EMERGENCY CONTACT

Emergency Contact Information *

RACE INFORMATION

Packet Pick Up? *
    

RELAY TEAM INFORMATION

Select Relay Category *
        
Team Name *
Swimmer Name *
Swimmer Gender *
    
Swimmer Email *
Swimmer USAT Number
Swimmer Shirt Size *
                    
Cyclist Name *
Cyclist Gender *
    
Cyclist Email *
Cyclist USAT Number
Cyclist Shirt Size *
                    
Runner Name *
Runner Gender *
    
Runner Email *
Runner USAT Number
Runners Shirt Size *
                    
Coupon Code
USAT *