BRC Triathlon

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Who are you registering? Choose one Yourself

Team name   First name   Last name   Email address   Age on event date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 Phone #   Address   Emergency contact name   Emergency phone #   Which Race? Choose one FUN TEAM XTREME

T-shirt size Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large XL 2X 3X View image Team Name (if selected team)

Please review the waiver provided by the event organizer and click the check box below to accept it. Print waiver Participation in the BRC Triathlon might involve a risk of injury, including bodily injury, and assume the risk for the same. On my behalf and on behalf of my heirs and legal representatives and to the fullest extent permitted by law, I hereby release and discharge the Burlington Recreation Commission, the recreation board, members, agents, and representatives of and from any and all liability for injury, death, damages and/or any other claims, demands, losses, or damages, incurred by me in connection with any aspect of the BRC Triathlon event. In case of inclement weather, we reserve the right to cancel or postpone. NO REFUNDS. I accept the terms of the waiver Name of parent or guardian who approves this activity Please enter your name here