Paragonah Sprint Triathlon 2019

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Team name   First name   Last name   Email address   Gender -- Male Female   Team Name if applicable Other     Team only: Swim, Bike or Run? Other     Phone #   Address   Emergency contact name   Emergency phone #   Distance Choose one Sprint Event 1/2 Sprint Event   Category Choose one Adult (18 & older) Child (Under 12) Junior (12-17) Team Relay Choose one Adult (18 & older) Child (Under 12) Junior (12-17) Team Relay   Event entry fee TBD

T-shirt size Choose One Adult Small Adult Medium Adult Large Adult Extra large Youth Small Youth Medium Youth Large Youth X-Large Swimming Level  * Choose One Beginning Intermediate Advanced   Who are you registering for?  * Choose One Yourself Someone Else

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Please review the waiver provided by the event organizer and click the check box below to accept it. Print waiver WAIVER: In consideration of the acceptance of my entry in the Paragonah Sprint Triathlon, I, the undersigned participant and , if less than 18 years of age, my parent or guardian, intending to be legally bound, do hereby for ourselves, and heirs, executors, administrators and assigns, forever waive, release and discharge any and all rights, claims and actions for damages that we or any of us may have, or that may hereafter accrue to us or any of us, against any and all persons, organizations and entities associated with the event, including but not limited to Parowan City, Paragonah Town and any or all sponsors of the event, Iron County, the State of Utah, volunteers, and individual race organizers, arising out of or in connection with my entry in, travel to, participation in, and returning from the Paragonah Sprint Triathlon. I attest and verify that I am physically fit and sufficiently trained to participate in this event. I understand that I am to obey all traffic laws and to give vehicles the right of way. I also understand I may have my picture taken and I give all rights to those pictures to the Paragonah Sprint Triathlon. UDOT - INDEMNIFICATION FORM The Permittee shall indemnify, defend and hold the State of Utah, the Utah Department of Transportation, the utah Transportation Commission, the Utah Highway Patrol and their officers, agents and employees harmless from and against any claim or demand for loss, liability or damage, including claims for bodily injury, wrongful death or property damage, arising out of or resulting from: (a) any act or omission by the Permittee, its officers, agents, employees or any persons under the Permittee's control insofar as permitted by law concerning Permittee's use or occupancy of the state road right-of-way; and (b) from and against all actions, suits, damages and claims brought or made by reasons of permittee's non-oberservance or non-performance of any of the terms of the Permit or the rules, regulations, ordinances and laws of the federal, state or local governments. UDOT - WAIVER AND REALEASE OF DAMAGES FORM Each of us individually (and/or as parent and/or guardian of the named minor) do hereby release, remise, waive and forever discharge the State of Utah, the Utah Department of Transportation, the Utah Transportation Commission, the Utah Highway Patrol, and their officers, agents, and employees from all liability, claims, demands, actions or causes of action whatsoever arising out of or related to loss, or damages and/or injuries, including death, which may result from my participation in the above named event involving roads within the state of Utah. I accept the terms of the waiver, UDOT Indemnification Form and Waiver and Release of Damages Form Name of parent or guardian who approves this activity and agrees to UDOT terms Please enter your name here (Parent/Guardian if under 18)