Printable Registration Form (please highlight the registration form and select "selection" on your print menu)
Kingswood Off-road Tri
Send completed registration info and Check or Money Order, payable to Vibrant Cycles, to:
Brickyard Bikes
700 N Chestnut St.
Chaska, MN, 55318
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LAST FIRST
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Birth Date (Area Code) Telephone Age Aug 22 M / F
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Street Address (include Apt # if indicated)
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City State Zip/Postal code
E-Mail Address: _______________________________________________________________________
INDIVIDUAL / TEAM
INDIVIDUAL:Age groups only (please circle one)
(Must be 16 years of age or older)
Age Group:
Male: 19 and under, 20-30, 30-40, 40-60, 60 and up
Female: 19 and under, 20-30, 30-40, 40-60, 60 and up
TEAM: All Male / All Female / Mixed (please circle one)
Team Note: Each Team Member to fill out registration form & send in together
Team Name________________________________________
Swimmer__________________________ Runner____________________________ Biker_________________________
Please read, understand and sign the following waiver: I know that swimming, biking, and running are potential hazardous activities. I should not enter and participate unless I am medically able and properly trained. I agree to abide by any decisions of a race official relative to my ability to safely complete the swim, bike, or run portions of the race. I assume all risks involved with participating in this event including, but not limited to: falls, contact with other participants, the affects of the weather including high heat and/or humidity, traffic and road conditions, all such risks being known and appreciated by myself. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I release Kingswood Off-road Triathlon, and all sponsors, their representatives and successors from all claims and liabilities arising out of my negligence or carelessness on the part of the persons named in this waiver.
Individual
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[Parent/Guardian’s signature if under 18 years of age ] Date
Team
Please note: Each Team Member to fill out Release form & send in together
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[Parent/Guardian’s signature if under 18 years of age ] Date