The Ulverstone Australia Day Aquathlon

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Team name   First name   Last name   Email address   Year of birth 01    01       YYYY 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922    Gender -- Male Female   Team member names Other     Club name Other     Phone #   Emergency contact name   Emergency phone #   Zip code / Postal code   Category Choose one Enticer 12-15 years NON member Enticer 12-15 years Tri Member Enticer 16-19 years NON member Enticer 16-19 years Tri Member Enticer 20+ Tri Member Enticer 20+ years Non member Parent with TryStar Team Sprint 14-19 years (Tri Member) Sprint 14-19 years Non member Sprint 20-39 years (Tri Member) Sprint 20-39 years Non Member Sprint 40-49 years (Tri Member) Sprint 40-49 years Non Member Sprint 50+ Non Member Sprint 50+ years (Tri Member) TEAM ONLY ENTICER 11+ TEAM ONLY SPRINT 12+ Try Stars 10-12 years Try Stars 7-9 years   Event entry fee TBD

Please review the waiver provided by the event organizer and click the check box below to accept it. Print waiver Participants under 18 years old must have parental/guardian approval to enter and further, the parent/guardian of the entrant must read and consent to all terms and conditions of entry. I certify I am the parent/guardian of a participant under 18 years of age/and I have read this document and fully understand it. I understand that it is my responsibility to ensure I/my child can complete the distance registered to compete in safely. If I am signing as the participants legal guardian, I have the legal authority to act for the participant and on their behalf. To participate in the event, the participant needs to be a current financial member of Triathlon Australia at the day of the event and have proof of current membership as either a current financial member or pay the one-day licence fee included in the registration. I understand that the compulsory insurance cover effected for participants in the event may not cover for any or all personal injury, loss or damage sustained by myself/my child. Safety precautions undertaken by organisers are a service, but do not guarantee safety. I agree I/my child will abide by all race rules and directions issued by the event organiser. I am fully responsible for the security of personal possessions at the event and the event organiser will not be liable for the replacement of any personal possessions. I consent for images and likeness before, during or after the event for promotional, broadcasting or reporting purposes in any media. The event organiser, in its sole discretion, may delay, modify or cancel the event for any reason, including if it believes the condition son the race day are unsafe. I accept the terms of the waiver Name of parent or guardian who approves this activity