![]() 14
ENTRY FORM BY TEAM
DECATRIATHLON WORLD CHALLENGE 2008
Swim time in 3.8 km_______________________
Name ______________________________________________________________
Name ______________________________________________________________
Name ______________________________________________________________
Address_____________________________________ City____________________
State__________________ Country________________ Zip Code ______________
Tel home____________________ Fax home_______________________________
Tel office____________________ Fax office________________________________
E-Mail ________________________________Birth date______________________
Category _______________ Sex______________ Age (on Nov 16th 2008)_________
T Shirt size (please circle): S M L XL
PH
Best Ultra triathlon races:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Waiver: I realize there are risks associated with competing in this event and in consideration of our accepting in this
entry, I, the below signed, intending to be legally bound for myself, my heirs, executors and administrators, waive
and against any persons, organizations, officials, and / or sponsors of the event that I will participate, named above,
and their representative, successors, and assigns for any and all injuries suffers by me in this event. I attest and
verify that I am physically fit and have sufficiently trained for the competition of this event. Further, I grant full
permission to any and all of the foregoing to use photographs, videotapes, motion pictures and recordings of me, or
other record of this event.
For legitimate purpose. Also, I understand that the race Director has the right to reject any entry form and
pull out any athlete from the race.
Signature_________________________ Date_________________________
PHOTO
PHOTO
PHOTO
PHOTO
|