Or just fill out this form and mail it in (Please print carefully)
NAME:__________________________________________________
ADDRESS:_______________________________________________
CITY:____________________________ STATE:____ ZIP:________
PHONE:___________________
SEX: ______ BIRTHDATE:___________ Per USAT Rules, your race age will be your age on Dec 31, 2009
EMAIL:_________________________________________________
USAT MEMBER? ___Yes USAT#__________________________
___No Non-members must purchase a $10 one-day
license in order to race
Including
each member of a relay team
DIVISIONS (please check one):
___ Age-Group (this is the standard category for most participants)
___ Professional (there will not be a pro wave. Pro's will be excluded from age-group awards)
___ Tri-Only - Clydesdale (male 200+ pounds may choose this division - will not be scored in age-group)
___ Tri-Only - Athena (female 150+ pounds may choose this division - will not be scored in age-group)
ORDER (please check one):
Triathlon Options:
___ Swim-Bike-Run
___ Swim-Run-Bike
___ Run-Swim-Bike
___ Run-Bike-Swim
___ Bike-Run-Swim
___ Bike-Swim-Run
Duathlon Options:
___ Run-Bike-Run
___ Bike-Run-Bike
Aquathlon Options:
___ Swim-Run-Swim
___ Run-Swim-Run
Aquabike Options:
___ Swim-Bike-Swim
___ Bike-Swim-Bike
Tech-Shirt Size: XS - S - M - L - XL - XXL
Unisex Sizes - Enter Early to
guarantee shirt size
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ENTRY FEES:
* ____ Individual through June 1st: $55
* ____ Individual June 2- July 1: $65
* ____ Individual July 2 – July 23: $70
* Entry
will close when race has filled
- There will be No Race Day Sign-Up -
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TOTAL FEES:
Entry Fee __________
USAT FEE __________
Coupon Code __________ $Amt________ (Discounts cannot be combined)
TOTAL ENCLOSED: __________
Send completed entry and make check payable to: Racing Underground, P.O. Box 7042, Golden, CO 80403
Entries will not be taken by phone or fax. Please see our refund Policy for information regarding refunds or transfers of entry.
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Please Read and Sign This Waiver
WARNING: READ CAREFULLY. THIS AGREEMENT INCLUDES A RELEASE OF LIABILITY AND WAIVER OF LEGAL RIGHTS AND DEPRIVES YOU OF THE RIGHT TO SUE USA TRIATHLON AND OTHER PARTIES. DO NOT SIGN THIS AGREEMENT UNLESS YOU HAVE READ IT IN ITS ENTIRETY. SEEK THE ADVICE OF LEGAL COUNSEL IF YOU ARE UNSURE OF ITS EFFECT.
2008 WAIVER AND RELEASE OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY
AGREEMENT
IN CONSIDERATION of USA Triathlon ("USAT") allowing me to
participate in any USAT sanctioned event (the "Event" or
"Events") as either a member of USAT or through the issuance of a
single event license or permit; I, for myself, and on behalf of my spouse, children,
parents, guardians, heirs and next of kin, and any legal and personal
representatives, executors, administrators, successors and assigns, hereby
agree to and make the following contractual representations pursuant to this
Waiver and Release of Liability, Assumption of Risk and Indemnity Agreement (the
"Agreement");
1. I hereby represent that (i) I am in good health and in proper physical
condition to participate in the Event; and (ii) I am not under the influence of
alcohol or any illicit or prescription drugs which would in any way impair my
ability to safely participate in the Event. I agree that it is my sole
responsibility to determine whether I am sufficiently fit and healthy enough to
participate in the Event.
2. I understand and acknowledge the physical and mental rigors associated
with triathlon, duathlon, or other multi-sport events, and realize that
running, bicycling, swimming and other portions of such Events are inherently
dangerous and represent an extreme test of a person's physical and mental
limits. I understand that participation involves risks and dangers which
include, without limitation, the potential for serious bodily injury, permanent
disability, paralysis and death; loss or damage to property; exposure to
extreme conditions and circumstances; accidents, illness, contact or collision
with other participants, spectators, vehicles or other natural or manmade
objects; dangers arising from adverse weather conditions; imperfect course
conditions; water, road and surface hazards; equipment failure; inadequate safety
measures; participants of varying skill levels; situations beyond the immediate
control of the Event Organizers; and other undefined harm or damage which may
not be readily foreseeable, and other presently unknown risks and dangers
("Risks"). I understand that these Risks may be caused in whole or in
part by my own actions or inactions, the actions or inactions of others
participating in the Event, or the acts, inaction or negligence of the Released
Parties defined below, and I hereby expressly assume all such Risks and
responsibility for any damages, liabilities, losses or expenses which I incur
as a result of my participation in the Event.
3. I agree to be familiar with and abide by the Rules and Regulations
established for the Event, including but not limited to the Competitive Rules
adopted by USAT and the Guide to Prohibited Substances and Prohibited Methods
of Doping adopted by the United States Anti-Doping Agency. I also accept sole
responsibility for my own conduct and actions while participating in the Event,
and the condition and adequacy of my equipment.
4. I hereby Release, Waive and Covenant Not to Sue, and further agree to
Indemnify, Defend and Hold Harmless the following parties: USAT, the Event
Organizers and Promoters, Race Directors, Sponsors, Advertisers, Host Cities,
Local Organizing Committees, Venues and Property Owners upon which the Event
takes place, Law Enforcement Agencies and other Public Entities providing
support for the Event, and each of their respective parent, subsidiary and
affiliated companies, officers, directors, partners, shareholders, members,
agents, employees and volunteers (Individually and Collectively, the
"Released Parties" or "Event Organizers"), with respect to any liability, claim(s),
demand(s), cause(s) of action, damage(s), loss or expense (including court
costs and reasonable attorneys fees) of any kind or nature ("Liability") which may arise out of, result from, or relate to
my participation in the Event, including claims for Liability caused in whole
or in part by the negligence of the Released Parties. I further agree that if,
despite this Agreement, I, or anyone on my behalf, makes a claim for Liability
against any of the Released Parties, I will indemnify, defend and hold harmless
each of the Released Parties from any such Liability which any may be incurred
as the result of such claim.
I hereby warrant that I have read this Agreement carefully, understand its
terms and conditions, acknowledge that I will be giving up substantial legal rights
by signing it (including the rights of the minor, my spouse, children, parents,
guardians, heirs and next of kin, and any legal and personal representatives,
executors, administrators, successors and assigns), acknowledge that I have
signed this Agreement freely and voluntarily, without any inducement, assurance
or guarantee, and intend for my signature to serve as confirmation of my
complete and unconditional acceptance of the terms, conditions and provisions
of this Agreement. This Agreement represents the complete understanding between
the parties regarding these issues and no oral representations, statements or
inducements have been made apart from this Agreement. If any provision of this
Agreement is held to be unlawful, void, or for any reason unenforceable, then
that provision shall be deemed severable from this Agreement and shall not
affect the validity and enforceability of any remaining provisions.
PRINTED NAME OF PARTICIPANT: AGE: _______ DATE OF BIRTH:
_______/_______/__________
PARTICIPANT'S SIGNATURE:
_______________________________________________________________ DATE:
_______/_______/__________
As the Parent and/or Legal Guardian to the minor identified above, I hereby
accept and agree to all of the terms and conditions of this Agreement in
connection with the minor's participation in the Event(s). If, despite this
Agreement, I, or anyone on the minor's behalf, makes a claim for Liability
against any of the Released Parties, I will indemnify, defend and hold harmless
each of the Released Parties from any such Liabilities which any may be
incurred as the result of such claim.
PARENT/GUARDIAN SIGNATURE (required if participant is under the age of 18):
________________________________________________________
DATE: _______/_______/__________
Modified 11/07