2021 MTC Event 4

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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   Emergency contact name   Emergency phone #   Distance Choose one Sprint Reverse Triathlon 3/9/3 Reverse Triathlon Have a Go Reverse Triathlon Long Duathlon Medium Duathlon Have a Go Duathlon Long Run/Swim Medium Run/Swim Have a Go Run/Swim   Age Group as at end of 2021 Choose one U13 Female U13 Male U16 Female U16 Male Junior Female Junior Male Open Female Open Male Vet 40 Female Vet 40 Male Vet 50 Female Vet 50 Male Vet 60 Female Vet 60 Male Vet 70 Female Vet 70 Male Choose one U11 Female U11 Male U13 Female U13 Male U16 Female U16 Male Junior Female Junior Male Open Female Open Male Vet 40 Female Vet 40 Male Vet 50 Female Vet 50 Male Vet 60 Female Vet 60 Male Vet 70 Female Vet 70 Male Choose one U11 Female U11 Male U13 Female U13 Male U16 Female U16 Male Junior Female Junior Male Open Female Open Male Vet 40 Female Vet 40 Male Vet 50 Female Vet 50 Male Vet 60 Female Vet 60 Male Vet 70 Female Vet 70 Male Choose one Junior Female Junior Male Open Female Open Male U13 Female U13 Male U16 Female U16 Male Vet 40 Female Vet 40 Male Vet 50 Female Vet 50 Male Vet 60 Female Vet 60 Male Vet 70 Female Vet 70 Male Choose one Junior Female Junior Male Open Female Open Male U11 Female U11 Male U13 Female U13 Male U16 Female U16 Male Vet 40 Female Vet 40 Male Vet 50 Female Vet 50 Male Vet 60 Female Vet 60 Male Vet 70 Female Vet 70 Male Choose one Junior Female Junior Male Open Female Open Male U11 Female U11 Male U13 Female U13 Male U16 Female U16 Male Vet 40 Female Vet 40 Male Vet 50 Female Vet 50 Male Vet 60 Female Vet 60 Male Vet 70 Female Vet 70 Male Choose one Junior Female Junior Male Open Female Open Male U13 Female U13 Male U16 Female U16 Male Vet 40 Female Vet 40 Male Vet 50 Female Vet 50 Male Vet 60 Female Vet 60 Male Vet 70 Female Vet 70 Male Choose one Junior Female Junior Male Open Female Open Male U11 Female U11 Male U13 Female U13 Male U16 Female U16 Male Vet 40 Female Vet 40 Male Vet 50 Female Vet 50 Male Vet 60 Female Vet 60 Male Vet 70 Female Vet 70 Male Choose one Junior Female Junior Male Open Female Open Male U11 Female U11 Male U13 Female U13 Male U16 Female U16 Male Vet 40 Female Vet 40 Male Vet 50 Female Vet 50 Male Vet 60 Female Vet 60 Male Vet 70 Female Vet 70 Male

Please review the waiver provided by the event organizer and click the check box below to accept it. Print waiver Manawatu Triathlon Club Inc. Events (‘the Event’) I declare that: 1. My accepted entry into the Event will not be transferred to another entrant. 2. In the event of any ‘act of God’ conditions (including Covid-19) causing a cancellation of the Event, I agree that my total entry fee is not transferable or refundable. 3. I am in an appropriate physical condition to participate in the Event, given the known parameters of the Event (such as the length, time, physical demands and environmental context). 4. I have taken medical advice on any pre-existing medical conditions, and confirm that it is medically safe for me to participate in the Event. 5. I acknowledge that there are risks involved in the Event. I fully realise the dangers of participating in the Event, and fully assume the risks associated with my participation and my wellbeing and safety during and after the Event. I understand and acknowledge that the Event organisers (including all officials and event volunteers) provide no warranties, regarding my wellbeing and safety. 6. I understand and agree that situations may arise during the Event, which may be beyond the immediate control of the Event organisers (including all officials and event volunteers). 7. I will participate in the Event, in a manner that does not endanger either me or others. 8. I agree that to the extent permissible by law, the Event organisers (including all officials and event volunteers), the sponsors and other parties associated with the Event, have no liability to me whatsoever for any direct or indirect loss, (including, but not limited to injury or death) sustained by me during or in any way related to my participation in the Event. 9. I authorise the use of my name, voice, picture and information on this entry form in any broadcast, telecast, promotion, advertising, and in any other way, without payment to me or any other form of compensation. 10. I agree to comply with the rules, and regulations pertaining to the Event including all public health measures. 11. I agree to follow all reasonable safety instructions provided to me by the Event organisers, (including all officials and event volunteers) before, during and after the Event. 12. I consent to receiving medical treatment in the event of illness or injuries suffered during or immediately after the Event. I accept the terms of the waiver Name of parent or guardian who approves this activity