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.
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________________________________________