MID-SUMMER TRIATHLON Entry Form
Sunday, August 3, 2008
Blue Lake Park, Troutdale, OR
Sprint Distance Tri**: 1/2 Mile Swim, 12-Mile Bike, 5K Run (8:00AM)
Tri-iT Novice Triathlon: 1/4 Mile Swim, 12-Mile Bike, 5K Run (8:00AM)
Sprint Distance Du*: 5K Run, 12-Mile Bike, 5K Run (8:00AM)
Olympic Distance*: 1.5k Swim, 40K Bike, 10K Run (8:30AM)


Web site: www.racecenter.com/midsummer
Email: events@racecenter.com
Phone: 503-644-6822


*TRI NorthWest Sprint Distance Championship
*TRI NorthWest Ranked Event (tri's & du)

Official Use Only

Instructions
> Type in your information in the blanks provided.
> Print entry form & SIGN WAIVER (Entry will not be accepted without the signed waiver)
> Make Checks Payable to:
Mid-Summer Triathlon

Mail to:
AA Sports, Ltd.
4840 SW Western Ave.
Suite 400
Beaverton, OR 97005

PACKET PICKUP: See website for information

Event (Choose One)

Individual
INDIVIDUAL (entry includes: T-shirt, finisher medal, Day Use Park Pass, ChampionChip Timing, awards, prizes, food, festivities, and great camaraderie. (TRI NorthWest members deduct $10.00 from entry fees)

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, Day Use Park Pass, ChampionChip Timing, awards, prizes, food, festivities, and great camaraderie.

First Name / MI / Last Name

Street Address


City

State/Province

Zip/Postal Code

Birthdate - mm/dd/yy (not 2008)

Age

Gender

Phone

Email

Division (Individual)


Special Divisions (Applies to Individuals ONLY)

RELAY MUST COMPLETE*
* Division (Combined three ages. If two on a team, take the person who is doing two disciplines and double it)

* Team Name (20 characters or less)

* Teammates Names:

Swimmer

Biker

Runner

T-Shirt Size (Each participant receives a 100% Cotton Short sleeved T-shirt, If you would like to upgrade to a 100% Polyester Performance T-shirt, please add $10.00 to entry fee.)

ChampionChip Number (if applicable - Example - CE12345)

TRI NorthWest Membership # (if applicable) - Members can deduct $10.00 from 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________________________________________