Indiana
Downs
Triathlon
& Duathlon
Web Entry 2008
Limited to the
first 400 individuals / 25 teams
Check which events
you wish to sign up for:
r
Triathlon r
Duathlon
Name:___________________________________ Age
on Dec 31, 08*______r Male r Female
Street:________________________________________________ Date
of Birth ___-___-___
City:________________________________________State:_____________ Zip:___________
Day Phone:_________________________ Evening Phone:___________________________
E-mail address
_____________________________________________________________
Tank Top Shirt size: rS r M r
L r XL r
XXL
Fees:
Triathlon Pre-registered
one week in advance - $55.00
per event - within one week - add $5.00
Duathlon - Pre-registered
one week in advance - $45.00
per event - within one week - add $5.00
Race day sign up - add $10.00
Teams one week before event - $81.00 -
within one week of event -
add $9.00
Race day sign up for teams is $99.00
Discounts - $10.00 if USAT Member, $5.00 if age
under 21, over 64 OR $5.00 if Military
(multiply discount by how many events you are doing)
Team Name ___________________________ (send team entries in together)
Check which team division: q Male q Female q Coed
q Visa q Mastercard
Card Number ________________________________ Exp. Date ___________ Amount
paid ___________
WARNING: READ CAREFULLY. THIS AGREEMENT INCLUDES A RELEASE OF LIABILITY AND
WAIVER OF LEGAL RIGHTS AND DEPRIVES YOU OF THE RIGHT TO SUE
USA
TRIATHLON AND OTHER PARTIES. DO NOT SIGN THIS AGREEMENT UNLESS YOU HAVE READ IT
IN ITS ENTIRETY. SEEK THE ADVICE OF LEGAL COUNSEL IF YOU ARE UNSURE OF ITS
EFFECT.
|
2008 WAIVER AND RELEASE OF LIABILITY,
ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
IN
CONSIDERATION of USA Triathlon (“USAT”) allowing me to participate in any
USAT sanctioned event (the “Event” or “Events”) as either a member of
USAT or through the issuance of a single event license or permit; I, for myself,
and on behalf of my spouse, children, parents, guardians, heirs and next of kin,
and any legal and personal representatives, executors, administrators,
successors and assigns, hereby agree to and make the following contractual
representations pursuant to this Waiver and Release of Liability, Assumption of
Risk and Indemnity Agreement (the “Agreement”);
1. I hereby
represent that (i) I am in good health and in proper physical condition to
participate in the Event; and (ii) I am not under the influence of alcohol or
any illicit or prescription drugs which would in any way impair my ability to
safely participate in the Event. I agree that it is my sole responsibility to
determine whether I am sufficiently fit and healthy enough to participate in the
Event.
2. I
understand and acknowledge the physical and mental rigors associated with
triathlon, duathlon, or other multi-sport events, and realize that running,
bicycling, swimming and other portions of such Events are inherently dangerous
and represent an extreme test of a person’s physical and mental limits. I
understand that participation involves risks and dangers which include, without
limitation, the potential for serious bodily injury, permanent disability,
paralysis and death; loss or damage to property; exposure to extreme conditions
and circumstances; accidents, illness, contact or collision with other
participants, spectators, vehicles or other natural or manmade objects; dangers
arising from adverse weather conditions; imperfect course conditions; water,
road and surface hazards; equipment failure; inadequate safety measures;
participants of varying skill levels; situations beyond the immediate control of
the Event Organizers; and other undefined harm or damage which
may not be readily foreseeable, and other presently unknown risks and
dangers (“Risks”). I understand that these Risks may be caused in whole or in
part by my own actions or inactions, the actions or inactions of others
participating in the Event, or the acts, inaction or negligence of the Released
Parties defined below, and I hereby expressly assume all such Risks and
responsibility for any damages, liabilities, losses or expenses which I incur as
a result of my participation in the Event.
3. I agree to
be familiar with and abide by the Rules and Regulations established for the
Event, including but not limited to the Competitive Rules adopted by USAT and
the Guide to Prohibited Substances and Prohibited Methods of Doping adopted by
the United States Anti-Doping Agency. I also accept sole responsibility for my
own conduct and actions while participating in the Event, and the condition and
adequacy of my equipment.
4. I hereby
Release, Waive and Covenant Not to Sue, and further agree to Indemnify, Defend
and Hold Harmless the following parties: USAT, the Event Organizers and
Promoters, Race Directors, Sponsors, Advertisers, Consolidated City of
Indianapolis, Local Organizing Committees, Venues and Property Owners upon which
the Event takes place, Law Enforcement Agencies and other Public Entities
providing support for the Event, and each of their respective parent, subsidiary
and affiliated companies, officers, directors, partners, shareholders, members,
agents, employees and volunteers (Individually and Collectively, the
“Released Parties” or “Event Organizers”), with respect to any liability,
claim(s), demand(s), cause(s) of action, damage(s), loss or expense (including
court costs and reasonable attorneys fees) of any kind or nature
(“Liability”) which may arise out of, result from, or relate to my
participation in the Event, including claims for Liability caused in whole or in
part by the negligence of the Released Parties. I further agree that if,
despite this Agreement, I, or anyone on my behalf, makes a claim for Liability
against any of the Released Parties, I will indemnify, defend and hold harmless
each of the Released Parties from any such Liability which any may be incurred
as the result of such claim
I hereby warrant that I have read this Agreement carefully, understand its terms
and conditions, acknowledge that I will be giving up substantial legal rights by
signing it (including the rights of the minor, my spouse, children, parents,
guardians, heirs and next of kin, and any legal and personal representatives,
executors, administrators, successors and assigns), acknowledge that I have
signed this Agreement freely and voluntarily, without any inducement, assurance
or guarantee, and intend for my signature to serve as confirmation of my
complete and unconditional acceptance of the terms, conditions and provisions of
this Agreement. This Agreement represents the complete understanding between
the parties regarding these issues and no oral representations, statements or
inducements have been made apart from this Agreement. If any provision of this
Agreement is held to be unlawful, void, or for any reason unenforceable, then
that provision shall be deemed severable from this Agreement and shall not
affect the validity and enforceability of any remaining provisions.
(Athlete or Participant)
Printed Name of Participant:______________________________________
Age ____ Date of Birth: ___-____-____
Participant's Signature _____________________________________________________
Date _______________
As the Parent and/or
Legal Guardian to the minor identified above, I hereby accept
and agree to all of the terms and conditions of this agreement in connection
with the minor's participation in the Event(s). If, despite this
Agreement, I, or anyone on the minor's behalf, makes a claim for Liability
against any of the Released Parties, I will indemnify, and hold harmless each of
the Released Parties from any such Liabilities which any may be incurred as the
result of such claim.
Parent / Guardian Signature (required if participant is under the age of 18):_____________________________ Date _______
Deadline for postmark is Monday before each race.
*- per USAT rules - Your age is determined by how
old you are at the end of the year.