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CACTUS MAN PERSONAL INFORMATION Last Name First Name Address City State Zip Gender Age Date of Birth// USAT Email Address Phone Number SHIRT Please circle Ladies Cut DISTANCE Men s Cut Medium Olympic CATEGORY Large Extra Large Sprint Clydesdale Athena Relay RELAY INFORMATION Team Name Swimmer Cyclist Runner FEES SPRINT Price through March 15 2017 100 Individual 165 Relay OLYMPIC March 16 March 31 2017 April 1 April 15 2017 205 Relay April 16 April 29 2017.

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