Registration
Register electronically through active.com click HERE
To Registration by mail please print and fill out the registration below.
Print this page first, then fill in the blanks and mail to:
Bountiful Triathlon.
240 Odell Ln
North Salt Lake, UT 84054
Make check payable to: Bountiful Triathlon.
MAIL ENTRY FORM WITH FEE BY July 28th.
Fees: $45 for individual prior to July 1st, $55 after July 1st. Relay $30 per person before July 1st, $40 after July 1st.
Bountiful Triathlon Registration Form Saturday, August 4, 2012
First Name __________________ Last Name __________________
Age on Aug. 4/12_______________ Gender __________________
Birth Date M/D/Y ______________ Phone # __________________
Address ____________________________________
City __________________ State __________________
Email ______________________________________________________
Tshirt size (circle one) XS, S, M, L, XL, XXL
Race entered (circle one) Individual or Relay Team
For Relays: Name of partner # 1 _________________________ Age_____ Gender ____
For Relays: Name of partner # 2 _________________________ Age_____ Gender ____
If relay team, name of team _________________________________________________
Mark one of the following:
I wish to be in my age group class
Or
I wish to be in the following special class:
Clydesdale (male over 200 lbs)
Athena (female over 150 lbs)
WAIVER. Knowing that participating in a road race is a potentially hazardous activity, I enter and run this race certifying that I am medically able and properly trained. I also know that, although police protection is provided, there may be traffic on the course route. I assume the risk of running in traffic. I also assume all other risks associated with running this event, including the effects of heat. I hereby, for myself, my heirs, executors, administrators or anyone else who might claim on my behalf, covenant not to sue, and waive, release, and discharge Bountiful Triathlon and all other parties associated with the race, including police and volunteers, from any and all claims to liability for death, personal injury or property damage of any kind or nature, arising out of, or in the course of, my participation in this event. The undersigned further grants full permission to use any photographs, videotapes, motion pictures, recordings, or any other record of this event for any purpose. I have read the foregoing and certify my agreement by my signature below.
Signature (by parent or guardian if participant is under 18):
________________________________________________________________________