Name_____________________________________________Age on Race Day___________
Address___________________________________________________Sex: M_____F_____
City______________________________State_________Zip________Day
Phone__________
Email address__________________________T-shirt size:
M_____L_____XL_____XXL_____
Team_____ If entering as a team, please list the names of all other team
participants
________________________
_________________________ _______________________
on the back of this application. Please submit all team members'
applications together in one envelope.
Entry Fee: Individual $40
Team Fees: $66 per team
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Make checks payable to Personal Fitness Specialists and send your
completed entry form and fee to: Sprint
Triathlon, Attn: Teresa Potts-Wade, 303 Amherst Ave,
Chattanooga, TN 37404
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| Release: I know that participation in a triathlon
sporting event is a potentially hazardous activity. I should not enter and
participate unless I am medically able and properly trained. I agree to
abide by any decision of a race official relative to my ability to safely
complete the event. I assume all risks associated with participating in
this event, including, but not limited to, falls, contact with other
participants, the effect of the weather, including high heat and/or humidity,
traffic and road conditions, all such risks being known and appreciated by
me. Having read this waiver and knowing these facts and in consideration
of your accepting my entry, I, for myself and anyone entitled to act on my
behalf, waive and release The Sports Barn, Hamilton County, and all sponsors,
their representatives and successors, from all claims or liabilities of any kind
arising out of my participating in this event even though that liability may
arise out of negligence or carelessness on the part of persons named in this
wiaver. |
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| Signature of Applicant:_________________________________________________Date_________________
If under 18, Parent or Guardian's
Signature__________________________________Date________________
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