TED DUTKIEWICZ MEMORIAL RACES
ENTRY FORM
(LIMITED TO 10 SCHOOLS)

ENTRY FEE $30.00 PER SCHOOL
DUE BY SEPTEMBER 17.
SCHOOL ___________________________________________________________

HEAD COACH'S NAMES _____________________________________________PHONE _____________

                                        _____________________________________________ PHONE ____________


EVENTS ENTERED (CHECK ALL THAT APPLY)

BOYS JV ________ GIRLS JV ________ BOYS VARSITY ________ GIRLS VARSITY ________
(9:00)                       (9:05 - IF NEC.)          (9:30)                                   (10:00)

SPECIAL TEE SHIRTS AWARDED TO THE TOP TEN (10) FINISHERS OF VARSITY RACES

TRAINER SHALL BE ON PREMISIS.


SIGNATURE OF ATHLETIC DIRECTOR OR PRINCIPAL

______________________________________


MAKE CHECKS PAYABLE TO:
MICHAEL BUDD
OR WMTF3CA

SEND TO:
MICHAEL BUDD/DUCKRACES
P.O. BOX 123
EAST LONGMEADOW, MASS. 01028-0123
TO CONFIRM ENTRY, EMAIL:

[email protected]
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