Mail to:
AA Sports, Ltd / Black Hills Triathlon
4836 SW Western Ave
Beaverton, OR 97005

Event (Choose One)

Individual - Triathlon & Duathlon (Fee includes: Commemorative T-shirt & Post Race BBQ)
TRI NorthWest members can deduct $10.00.
- TRI - Individual (on or before Aug 27th) - $75.00 TRI - Individual (on Aug 28 through Sept 9) - $80.00 TRI - Individual (PU/DOR) - $85.00 DU - Individual (on or before Aug 27th) - $75.00 DU - Individual (on Aug 28 through Sept 9) - $80.00 DU - Individual (PU/DOR) - $85.00

Relay - Three Person (EACH PERSON MUST FILL OUT SEPARATE ENTRY FORM & ALL 3 MUST BE MAILED IN TOGETHER)
- Triathlon Relay - $40ppr (on or before August 27th) Triathlon Relay - $45ppr (on August 28 through Sept 9) Triathlon Relay - $50ppr (PU/DOR) Duathlon Relay - $40ppr (on or before August 27th) Duathlon Relay - $45ppr (on August 28 through Sept 9) Duathlon Relay - $50ppr (PU/DOR)

First Name / MI / Last Name

Street Address

City

State/Province

Zip/Postal Code

Birthdate - mm/dd/yy

Age

Gender
- Female Male
Phone

Email

Division (Individual)

- 14 & under 15 - 17 years 18 - 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 - 74 years 75 - 79 years 80 years & over
Special Divisions (Applies to Individuals ONLY)

- Clydesdales (males 198lbs and over) Athena (females 150lbs and over)
RELAY MUST COMPLETE* (Combined three ages. If two on a team, take the person who is doing two disciplines and double it)
* TRIATHLON DIVISION
- 105 & Under - All Men 105 & Under - All Women 105 & Under - Mixed 106 & Over - All Men 106 & Over - All Women 106 & Over - Mixed
* DUATHLON DIVISION
- 70 & Under - All Men 70 & Under - All Women 70 & Under - Mixed 71 - 90 - All Men 71 - 90 - All Women 71 - 90 - Mixed 91 & Over - All Men 91 & Over - All Women 91 & Over - Mixed
* Team Name (20 characters or less)

* Teammates Names:

Swimmer

Biker

Runner

T-Shirt Size (included with entry fee)
- S M L XL XXL (add $2.00)
ChampionChip Number (if applicable - Example - CE12345)

TRI NorthWest Membership # (if applicable) - members deduct $10.00

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/Non-Transferable.

Type Full Name


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

Date________________________________________