Townsville Triathlon Club

Individual/Team Contact First Name*

Individual/Team Contact Last Name*

Team Details

Swimmer

Cyclist

Runner

Gender*
 Male Female

Date of Birth (dd/mm/yy)*

Occupation

TA/TQ Member#

Townsville Tri Club Race# (if applicable)

Address (Include Suburb and Postcode)*

Home Phone*

Mobile Phone

Email*

Tri Club or Group

Emergency Contact (This person must be contactable during the event)*

Race Entry*
Individual Main EventIndividual EnticerIndividual JuniorIndividual TRYstar KidsTeams Main EventTeams Enticer

Event Category*

Individual Main Event:
 A 16-19 B 20-24 C 25-29 D 30-34 E 35-39 F 40-44 G 45-49 H 50-54 I 55-59 J 60-64 K 65-69 L 70+

Individual Junior/Enticer:
 YY 13-15 AA 16-19 BB 20-24 CC 25-29 DD 30-34 EE 35-39 FF 40-44 GG 45-49 HH 50-54 II 55-59 JJ 60-64 KK 65-69 LL 70+

TRYstar Kids:
 T 8-10 T 11-12

Teams:
 TA Enticer Adult TJ Enticer Junior TM Main Male TF Main Female TX Main Mixed

Declaration

WARNING: This is a legal document that affects your rights.
(1) I acknowledge that competitive triathlon involves the real risk of serious injury or event death from various causes including over exertion, equipment failure, dehydration, accidents with other competitors, spectators or road users, course or weather conditions and other causes. (2) I understand that I should not compete in this event unless I have trained appropriately and a medical practitioner has verified my physical condition. (3) By competing, I accept all risk necessarily following from my participation and I hereby indemnify them against all liability (including liability for their negligence and the negligence of others) for all injury, conduct of the event from all claims demands and proceedings arising out of my participation in this event. This release shall extend to and include Triathlon Australia Inc., Triathlon Queensland Inc., Townsville Triathlon Club Inc., and their respective directors, partners, managers, officers, agents, contractors, employees and volunteers including medical and paramedical personnel appointed for the event, the owners, licensees and occupiers of land upon which the event or any part of it is conducted, any statutory body or local authority having control over land upon which the event or any part of it is conducted or which is involved directly or indirectly with the vent in any manner whatsoever and promoters, sponsors and event organisers. This release and indemnity continues forever and bind my heirs, executors, personal representatives and assigns. (4) I consent to receiving any medical treatment including ambulance transportation that the event organisers think desirable during or after the event. (5) I consent to event organisers using my name, image and likeness before, during or after the event for the event promotional broadcasting or reporting purposes in any media. (6) I understand that compulsory insurance cover affected for participants in this event may not cover me for any or all injury, loss or damage sustained to me. (8) Safety precautions undertaken by organisers (such as course supervision, race safety briefings, bicycle and helmet safety checks) are a service to me and other competitors but are not a guarantee of safety. (9) My registration is not transferable to other people. If I am unable to compete, or if the event is cancelled by way of circumstances beyond the control of the event organisers, my registration fee is non-refundable. (10) I have listed below my medical and physical conditions from which I suffer that might affect my performance or be relevant if medical or physical conditions harm which I suffer that might affect my performance or be relevant if medical treatment is needed. I accept the risk of competing, despite these conditions. (11) I agree to abide by all race rules and directions issued by Triathlon Australia and the event organisers. (12) Event organisers may change the event format, course or other race conditions at their discretion. If that occurs, this agreement applies to the changed conditions.

MEDICAL OR PHYSICAL CONDITIONS (see Item 10)

Terms and Conditions Agreement*
 Yes, I understand and agree to the above terms and conditions

If you have any questions regarding these conditions please contact the club directly.

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