Mail in form, info and entry fee.  Release forms will be completed on-site prior to racing. 

Mail to:    AVC entry            Check payable to:  Portland Velodrome Committee
            4318 SE 8th Ct.

            Gresham, OR 97080

Name: __________________________________________________________________ 



Address: _______________________________________________________________


City: ______________________    State:  _________    Zip: _______________ 


E-mail: ______________________ 


Phone: ______________________ 


Track Category: ___________ 


Home track: ______________________ 


Races and entry fees:
Entry fees in $US must accompany entry.

Men
____ Qualifier points race $10
     (If not pre-qualified)
____ 4K Pursuit $5
____ Kilometer TT $5

____ Sprints $10
____ 10 mile $10
____ Miss & Out $10
____ Points $10
____ Keirin $10
____ Madison $5/rider
____ Olympic Sprint $5/rider

____ Flying Lap (no entry fee)



Women                             Masters 40+                 Masters 50+
____ 3K Pursuit $5                ____ Pursuit $5             ____ 500 m TT $5
____ 500 m TT $5                  ____ Kilo TT $5             ____ 2K Pursuit $5
____ Sprints $10                  ____ Sprints $10
____ 10 mile $10                  ____ 10 mile $10
____ Miss & Out $10               ____ Miss & Out $10

____ Points $10                   ____ Points $10
____ Keirin $10                   ____ Keirin $10
____ Flying Lap (no entry fee)    ____ Qualifier Points race
                                       (if not Cat 1 or 2)