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ChampionChip Order Form

Join the 21st Century today! Be ahead of your time. Be the first on your block to own your own ChampionChip. Guaranteed for life, and usable world-wide in a growing number of events, owning your own ChampionChip identifies you internationally as a ChampionChip runner who has made a commitment to the sport. Join the regional and global database of Chipsters!

As the ChampionChip becomes established in races in the Washington, DC, metropolitan area, race directors are beginning to offer a $2 or more discount to runners who own, rather than rent, a Chip. Save on entry fees and save time at registration! The active runner will quickly recoup the cost of the ChampionChip.

Please fill out the order form completely and legibly. We will enter you into the international database of Chip owners, accessible by race directors worldwide.

Name: __________________________________________________________
      First                 Middle           Last
Address: _______________________________________________________

City: ___________________________ State: _______ Zip: __________
Birthdate: ___/___/______ Sex: M F Phone: (_____)_____________
E-mail address: ________________________________________________
All prices include sales tax, shipping, and handling.
____ $35 ChampionChip ____ $3 Velcro ankle strap
____ $5 Neoprene ankle strap ____ $3 Shoelace velcro strap
Total Enclosed: $______
Make check payable to Capital Running Company and mail to: ChampionChip, 13710 Ashby Road, Rockville, MD 20853-2903.
Or, pay by credit card. You may fax your order to (301)871-0006.
____ Visa ____ MasterCard Expiration Date: ____/______
Card number: _______ - _______ - _______ - _______
______________________________________________ ________________ Cardholder's signature Date


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