Loop De Lori Sign Up

Loop de Lori Triathlon & 5k

September 10th, 2022
Full Name *

First Name Last Name
Phone Number *
Email Address *
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Age *
Male/Female *

Male Female
Shirt Size *
Triathlon Race Category
Choose One *

Youth (age 12-16) Female (49 and under) Female (50 and over) Male (49 and under) Male (50 and over) 5K 2 Person Team 3 Person Team 4 Person Team
Team Registration

For 2 - 4 person teams. Skip if you are signing up as an individual.
Team Name **Must Enter A Team Name
2) Name

First Name Last Name
2) Email
example@example.com
2) Phone Number
Shirt Size
3) Name

First Name Last Name
3) Email
example@example.com
3) Phone Number
Shirt Size
4) Name

First Name Last Name
4) Email
example@example.com
4) Phone Number
Shirt Size
Payment *
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5K (Fun Walk/Run)
$ 30.00

5K Timed Race
$ 35.00

Triathlon
$ 50.00

Triathlon (2 person team)
$ 100.00

Triathlon (3 person team)
$ 150.00

Triathlon (4 person team)
$ 200.00

Donation
$ 20.00

Total

$ 0.00
When finished filling out sign up form, select your payment above. Click submit below and you will be redirected to Paypal to complete your payment.
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Loop de Lori Triathlon & 5k