Mail Registration and Non-Refundable Race Fees (Check or Money Order) to

Terra Firma Promotions, LLC
3113 Lake Highlands Drive
Highland Village, Tx 75077
972-966-1300

Please circle a CATEGORY:

DIRTY DOZEN 12 HOUR RACE:

$75.00 per rider pre-registration / $85.00 per rider race day registration

ARE YOU RIDING A SINGLE SPEEED?__________

5 person   4 Open    4 Female    4 Masters     4 Coed   2 Male     2 Female

2 Coed       Solo female            Solo male sport             Solo male expert

SUPER SIX (6) HOUR RACE:

$55.00 per rider pre-registration / $65.00 per rider race day registration

2 Open      Solo Female       Solo Male

Team Name:______________________________________________________

Team Captain Name:_______________________________________________

Address:_________________________________________________________

City:__________________________ State:_____________

Zip:_______ Email:(Prerace Info)__________________________________

Home Phone:______________________________________________

Cell Phone:______________________________________________

Emergency Contact: __________________________________________

Ages on 12/31/2009:(1)_____ (2)_____ (3)_____ (4)______ (5)_______

T-Shirt Sizes:(S,M,L,XL,XXL)_________________________________________

Team Members: Captain: (1.)________________________________