Vail Valley Marathon Registration Form

Please use your browser to print this page. After entering your information in the form, please fax it to 970-555-0922 or mail it to:

Vail Valley Marathon
P.O. Box 159800
Vail, CO 81657

If we receive your registration before May 23, then we will mail your t-shirt and registration packet to the address that you supply.

□ Please check here if you want to pick up your race items at the registration booth on the day of the race and do not wish to have them mailed to you.

Name: __________________________________________________________________

Address: ________________________________________________________________

City: ____________________________________________________________________

State/Province: ____________________________________________________________

Zip/Postal Code: __________________________________________________________

Country (check one) _____ United States _____ Canada _____ Other

E-mail Address: ___________________________________________________________

Home Phone: _____________________________________________________________

Gender
□ Male
□ Female

Age (on May 31)
□ 5-12
□ 13-18
□ 19-35
□ 36-50
□ 51-65
□ over 65

Do you wish to enter in one of the following special categories, instead of in the age group in which you registered?
□ Wheelchair
□ Clydesdale (men, over 190 pounds)
□ Filly (women, over 160 pounds)

T-shirt Size
□ Small
□ Medium
□ Large
□ Extra Large

Credit Card Number: _______________________________________________________

Expiration Date (month and year): ______________________________________________

By signing below, I acknowledge that a physical examination is not required to run the Vail Valley Marathon and that I am participating in this event at my own risk. I also acknowledge that my credit card will be charged for the registration fee.

________________________________________________________________________
Signature                                                                                             Date