2009 Snake River Sprint Triathlon 2009
ENTRY FORM
April 10 (4-8pm) – Swim Portion
April 11 (10:00am) – Bike & Run
Hell’s Gate State Park Lewiston, Idaho
Make Checks Payable to and SEND TO:
LCSC Cross Country C/O Dr. Mike Collins 500 8th Avenue Lewiston, ID 83501
CHO0SE CATEGORY:
[ ] Individual with Shirt - - - - - - - - $35.00
[ ] Individual without Shirt - - - - - - $25.00
[ ] 2-Person Team with Shirts - - - - - - $45.00
[ ] 2-Person Team without Shirts - - - - - - - $35.00
[ ] 3-Person Team with Shirts -- - - - - -$50.00
[ ] 3-Person Team without Shirt- - - - - - - $40.00
[ ] Late Fee per Person - - - - - - - - - - - - - - - $5.00-$10.00 (AFTER
March 29)
If TriNW Member, your $5.00 refund will be given at Packet pickup on race
morning with card.
WILL YOU BE SWIMMING: YES NO Estimated Swim Time (500 yards): ____________
INDIVIDUAL OR TEAM ENTRY (RUNNER)
Name: ____________________________________ Address: ___________________________
City: ___________________ State: _______ Zip: __________ Phone: ( )
_____________
Age: _____ Email: _______________________________________________Birthday: ____
/ ___/____
TriNW #: _________ Gender: M or F Shirt Size: Sm Med Large XL
IF TEAM ENTRY (CYCLIST)
Name: ____________________________________ Address: ___________________________
City: ___________________ State: _______ Zip: __________ Phone: ( )
_____________
Age: _____ Email: _______________________________________________Birthday: ____
/ ____ / ____
TriNW #: _________ Gender: M or F Shirt Size: Sm Med Large XL
IF TEAM ENTRY (SWIMMER)
Name: ____________________________________ Address: ___________________________
City: ___________________ State: _______ Zip: __________ Phone: ( )
_____________
Age: _____ Email: _______________________________________________Birthday: _____
/ _____ / _____
TriNW #: _________ Gender: M or F Shirt Size: Sm Med Large XL
Please Read the Following statement and sign below before submitting entry.
I know that competing in a triathlon is a potentially hazardous activity. I
should not enter and compete unless I am
medically able and properly trained. I assume all risks associated with
competing in this event, including, but not limited
to falls, contact with other participants, the effects of weather, traffic,
interactions with non-participants and the conditions
of the road all such risks being known and appreciated by me. Having read this
waiver and knowing these facts and in
consideration of the acceptance of my entry, I, myself and anyone entitled to
act on my behalf, waive and release any
and all sponsors and organizers, their officers, agents and assigns, the race
director and volunteers from all claims or
liabilities of any kind arising out of my participation in this event even
though that liability may arise out of the negligence
or carelessness on the part of the persons named in this waiver. I also
understand that my entry fee is non-refundable and
non-transferable. A parent must sign if the child is under 18 years of age. This
certifies that the child has permission to
participate and agrees to the previously stated waiver.
ACTS OF GOD & OTHERS DISCLAIMER: Although it is not anticipated that weather,
road construction, etc.. will
affect the race. The race organizers reserve the right to adjust the course, the
time of the race and anything other
compensations necessary due to factors beyond their control which includes, but
is not limited to weather, road
construction, ... In eleven years of putting on these races we have never had to
worry about this type of an event, but want
to be sure that any and all participants are aware that it could happen and that
we will make every effort to conduct the
race to the best of our ability with the safety of all participants and
volunteers in mind.
Signature: _____________________________________ Date: _________________
Signature: _____________________________________ Date: _________________
Signature: _____________________________________ Date: _________________
(PARENT if entrant is under age of 18)