Team Participation
All fields are required except weight and comments box.
Team Name
Sponsor?
Age Division
Average age of team
determines division. See chart
 Total Team
Weight
* Optional
_______________________________________________________
Team Captain
Address
City
State
 Zip
Telephone
Email
T-Shirt Size
Attend June 14 kickoff?
 Yes
 No
_______________________________________________________
Teammate #2
Email
T-Shirt Size
Attend June 14 kickoff?
 Yes
 No
Teammate #3
Email
T-Shirt Size
Attend June 14 kickoff?
 Yes
 No
* Comments or
Questions?
* Optional
AGE and GENDER DIVISIONS
For teams, average age of
teammates determines division.
    Division 1: 10 - 15
    Division 2: 16 - 20
    Division 3: 21 - 25
    Division 4: 26 - 30
    Division 5: 31 - 35
    Division 6: 36 - 40
    Division 7: 41 - 45
    Division 8: 46 - 55
    Division 9: 56 - 65
    Division 10:  66+
Pounds Lost
 Points
10 - 20
 5
21 - 30
 10
31 - 40
 15
41 - 50
 20
51 - 60
 25
61 - 70
 30
71 - 80
 35
81 - 90
 40
91 - 100
 45
100 +
 50
Weight Loss Points
QUESTIONS?
Contact Dennis Ketterman
Alternatives Magazine
406-765-1401
Email: dennisk@nemont.net
PAY?
You may pay by check or by credit card.
By check:
Payable to Mountain Publishing
P.O. Box 493
Plentywood, MT 59254.

By credit card:
Click on the Pay Now button below and follow the instructions.
* Participation in the weight
loss program is OPTIONAL.
By filling in the Combined
Team Weight box above
indicates participation.

Teams must weigh in prior to
each check in date to provide
a progress report which will
be posted along with the
miles/points charts.  
Individual weight of
teammates is not required.