Mail to:
Kirkland Tri
c/o AA Sports, Ltd.
4840 SW Western Ave.
Suite 400
Beaverton, OR 97005

Event (Choose One)

Individual
(ENTRY FEES INCLUDE: Commemorative T-shirt, ChampionChip Timing, Finisher Medal, Post Race BBQ - TRI NW Members can deduct $10.00 from entry fee, with valid membership #)
- Triathlon Individual - $70 (received on or before 9/11) Triathlon Individual - $75 (received between 9/11 - 9/19) Triathlon Individual - $80 (Packet Pickup 9/20 - 9/21) Duathlon Individual - $70 (received on or before 9/11) Duathlon Individual - $75 (received between 9/11 - 9/19) Duathlon Individual - $80 (Packet Pickup 9/20 - 9/21) TRI-IT - $70 (received on or before 9/11) TRI-IT - $75 (received between 9/11 - 9/19) TRI-IT - $80 (Packet Pickup 9/20 - 9/21) KID'S - $20 (Race Day is Saturday, Sept 20th)

Relay - Three Person (EACH PERSON MUST FILL OUT SEPARATE ENTRY FORM & ALL 3 MUST BE MAILED IN TOGETHER)
INDIVIDUAL (entry includes: T-shirt, finisher medal, ChampionChip Timing, awards, prizes, food, festivities, and great camaraderie)
- Triathlon Relay Team - $35 (received on or before 9/11) Triathlon Relay Team - $40 (received between 9/11 - 9/19) Triathlon Relay Team - $45 (Packet Pickup 9/20 - 9/21) Duathlon Relay Team - $35 (received on or before 9/11) Duathlon Relay Team - $40 (received between 9/11 - 9/19) Duathlon Relay Team - $45 (Packet Pickup 9/20 - 9/21)

First Name / MI / Last Name

Street Address

City

State/Province

Zip/Postal Code

Birthdate - mm/dd/yy (not 2008)

Age

Gender
- Female Male

Phone

Email

Division (Individual)

- 15 - 19 years 20 - 24 years 25 - 29 years 30 - 34 years 35 - 39 years 40 - 44 years 45 - 49 years 50 - 54 years 55 - 59 years 60 - 64 years 65 - 69 years 70 years & over
Special Divisions (Applies to Individuals ONLY)

- Clydesdales (males 198lbs and over) Athena (females 150lbs and over) Family and Friends
RELAY MUST COMPLETE*
* Division (Combined three ages. If two on a team, take the person who is doing two disciplines and double it)
- 105 & Under - All Men 105 & Under - All Women 105 & Under - Mixed 106 & Over - All Men 106 & Over - All Women 106 & Over - Mixed
* Team Name (20 characters or less)

* Teammates Names:

Swimmer

Biker

Runner

T-Shirt Size (Each participant receives a 100% Cotton Short sleeved T-shirt)
- Youth Small (Kid's) Youth Medium (Kid's) Youth Large (Kid's) Small Medium Large X-Large XX-Large (add $2.00 to entry)
ChampionChip Number (if applicable - Example - CE12345)

TRI NorthWest Member # (if applicable) - Members can deduct $10.00 from their entry fee

Check#

Amount Enclosed


WAIVER MUST BE READ, SIGNED AND MAILED WITH ENTRY
OFFICIAL WAIVER: I acknowledge that a Multi-Sport Event is an extreme test of a person's physical and mental limits and carries with it the potential for death, series injury, and property loss. I HEREBY ASSUME THE RISKS OF PARTICIPATING IN THIS EVENT. I certify that I am capable of completing all disciplines of the event, and that I am physically fit and that I have sufficiently trained. I agree to abide by the competitive rules. I hereby take the following action for myself, my executors, administrators, heirs, next to kin, successors and assigns, or anyone else who might claim or sue on my behalf, and I hereby waive, release and discharge from any and all claims, losses, or liabilities for death, personal injury, partial or permanent disability, property damage, medical or hospital bills, or theft which may arise out of or relate to my participation in this event. I agree not to sue, and to hold harmless any and all persons, sponsors, volunteers, participants or government agencies for any and all claims or liabilities that I have waived, released or discharges herein. I further agree to return the timing Chip that is been issued to me or to pay a $30 replacement charge. The Entry Fee is Non-Refundable.

Type Full Name


Signature X ___________________________________________________________________
(Signature of Parent or Legal Guardian if participant is under the age of 18)

Date________________________________________