Registration
Welcome!It's great to have you back.
You will receive confirmation within 24 hours.
Please Complete ALL Information

Name
Address
City
State
Zip
Primary Phone
The phone listed above is my
Email
Age
Date of Birth
What was the best part of your past triathlon training?


Now that you have at least one race under your belt, do you have any specific goals for the upcoming year?
Would you personally do anything different this year associated with your training?
Which answer best describes you this year?
I want to do an Olympic distance race (twice the distance of Danskin).
Danskin is long enough, but I want to go faster.
I would like to keep things the same. I want to participate and have a good time.
HEALTH QUESTIONNAIRE
Please answer the following questions by checking Yes or No
Have a family history of heart disease?



Have high blood pressure?
If yes, are you on medication?
If yes, is it a beta blocker?
Do you smoke?
Do you take any medication?
If so, please explain:
Do you have diabetes?
Do you have chronic joint or muscle pain?
If yes, please explain:
Could you be pregnant?
Have you been pregnant in the last three months?
Has a doctor ever
suggested you limit your physical activity?
If yes, please explain:
Is there anything else I should know about your health history?
If yes, please explain:
It is recommended that everyone get a complete physical before starting a program of physical activity
All the information on this form is correct to my knowledge.
Please retype your name:
Date:
WAIVER AND RELEASE FROM LIABILITY:
PLEASE READ CAREFULLY

I acknowledge that training for a triathlon, and other endurance sports to be a test of physical and mental limits, and carries with it the potential for serious injury. I hereby assume the risk of participating in this program, in the triathlon and in the training of said triathlon. I certify that I have not been advised against participation by a qualified health professional.

I agree that prior to participating in the event or a training session I will inspect my equipment, and areas to be used and if I believe any are unsafe I will immediately advise the person supervising the event activity, facility, or area. I waive, release and discharge Susan Waldrop, the USAT, and all facilities used, from any and all claims, losses, or liabilities associated with participation in this program.

I acknowledge that there may be traffic or persons on the course route, and I assume the risk of running, biking and swimming in a race or while training. I also assume any and all other risks associated with participating in this triathlon program organized by Susan Waldrop including but not limited to falls, contact and/or effects with other participants, effects of weather including heat and/or humidity, defective equipment, the condition of the roads, and water hazards. All such risks are known and acknowledged by me.

I grant permission for the use of my name and/or likeness relating to my participation in this triathlon program, and I waive all right to any future compensation to which I may otherwise be entitled as a result of the use of my name or likeness.

I HEREBY AFFIRM THAT I AM EIGHTEEN (18) YEARS OF AGE OR OLDER, I HAVE READ THIS DOCUMENT, AND I UNDERSTAND ITS CONTENT.
 
PLEASE RETYPE YOUR NAME . THIS WILL BE YOUR OFFICIAL SIGNATURE FOR THE WAIVER RELEASE.