RELAY ONE-DAY CLUB MEMBERSHIP
Kona Monster and Mini Monster Triathlon
Sunday February 10, 2013
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MONSTER___ MINI MONSTER___
Relay Team SWIMMER
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SWIM
Last Name ______________________________________
First Name ___________________________ MI ________
Address ________________________________________
Town _________________________________________
State / Provence _________________________________
Zip / Country Code _______________________________
Country ________________________________________
e-mail __________________________________________
Contact Phone (______) ________ - _________________
Gender M___ F ___ Age on 2/10/2013 _____
T-Shirt size: Sm ___ Med ___ Lg ___ XL ___ XXL ___
Amount donation enclosed $ 78.00 per Team
Mail in your filled out entry forms signed please and Team
Mango donation checks made payable to:
Team Mango Races, PO BOX 757, Holualoa, HI 96725
|
Release: I agree to receive mailings from Team Mango
Races vendors which, does not obligate me to purchase
any athletic related products.
I GIVE PERMISSION for free use of my name, voice or
picture in any broadcast, telecast, advertising promoting
or other account of this event.
I agree to comply with rules, regulations, and event
instructions of the Monster and Mini Monster Triathlon. I
understand that participating in an Ultra Distance
Triathlon is potentially hazardous activity and can be
result in serious injury or death.
I am aware of and expressly assume all inherent risks
associated with participating in this event, including, but
not limited to falls, contact with other participants, and
objects, the effects of weather, including high heat and
humidity, traffic, and the conditions of the Triathlon
course and the finish area. ______initial
IN CONSIDERATION: of your accepting this entry, I for
myself and anyone entitled to act on my behalf, waive
and release from any and all claims for injury and
damages I may have against Team Mango Races, the
Village of Kailua, Kona County, the State of Hawaii, the
United States of America, the Sponsors, Event
Volunteers, their agents and representatives caused by
negligence of any of them arising out of my participating
in this event, including pre and post-race activities. I
ATTEST that I am physically fit and have a sufficiently
trained for competition of the Monster and Mini Monster
Triathlon. ____initial
I CONSENT to receive Medical treatment which may be
advisable in the event of illness or injury suffered by me
during this event and agree to pay for the costs of my
Medical treatment. ____initial
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SIGNATURE __________________________________________________ Date ___/___/20___
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MONSTER___ MINI MONSTER___
Relay Team BIKER
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BIKE
Last Name ______________________________________
First Name ___________________________ MI ________
Address ________________________________________
Town _________________________________________
State / Provence _________________________________
Zip / Country Code _______________________________
Country ________________________________________
e-mail __________________________________________
Contact Phone (______) ________ - _________________
Gender M___ F ___ Age on 2/10/2013 _____
T-Shirt size: Sm ___ Med ___ Lg ___ XL ___ XXL ___
Amount donation enclosed $ 78.00 per TEAM
Mail in your filled out entry forms signed please and Team
Mango donation checks made payable to:
Team Mango Races, PO BOX 757, Holualoa, HI 96725
|
Release: I agree to receive mailings from Team Mango
Races vendors which, does not obligate me to purchase
any athletic related products.
I GIVE PERMISSION for free use of my name, voice or
picture in any broadcast, telecast, advertising promoting
or other account of this event.
I agree to comply with rules, regulations, and event
instructions of the Monster and Mini Monster Triathlon. I
understand that participating in an Ultra Distance
Triathlon is potentially hazardous activity and can be
result in serious injury or death.
I am aware of and expressly assume all inherent risks
associated with participating in this event, including, but
not limited to falls, contact with other participants, and
objects, the effects of weather, including high heat and
humidity, traffic, and the conditions of the Triathlon
course and the finish area. ______initial
IN CONSIDERATION: of your accepting this entry, I for
myself and anyone entitled to act on my behalf, waive
and release from any and all claims for injury and
damages I may have against Team Mango Races, the
Village of Kailua, Kona County, the State of Hawaii, the
United States of America, the Sponsors, Event
Volunteers, their agents and representatives caused by
negligence of any of them arising out of my participating
in this event, including pre and post-race activities. I
ATTEST that I am physically fit and have a sufficiently
trained for competition of the Monster and Mini Monster
Triathlon. ____initial
I CONSENT to receive Medical treatment which may be
advisable in the event of illness or injury suffered by me
during this event and agree to pay for the costs of my
Medical treatment. ____initial
|
SIGNATURE _________________________________________________ Date ___/___/20___
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MONSTER___ MINI MONSTER___
Relay Team Runner
|
RUN
Last Name ______________________________________
First Name ___________________________ MI ________
Address ________________________________________
Town _________________________________________
State / Provence _________________________________
Zip / Country Code _______________________________
Country ________________________________________
e-mail __________________________________________
Contact Phone (______) ________ - _________________
Gender M___ F ___ Age on 2/10/2013 _____
T-Shirt size: Sm ___ Med ___ Lg ___ XL ___ XXL ___
Amount donation enclosed $ 78.00 per TEAM
Mail in your filled out entry forms signed please and Team
Mango donation checks made payable to:
Team Mango Races, PO BOX 757, Holualoa, HI 96725
|
Release: I agree to receive mailings from Team Mango
Races vendors which, does not obligate me to purchase
any athletic related products.
I GIVE PERMISSION for free use of my name, voice or
picture in any broadcast, telecast, advertising promoting
or other account of this event.
I agree to comply with rules, regulations, and event
instructions of the Monster and Mini Monster Triathlon. I
understand that participating in an Ultra Distance
Triathlon is potentially hazardous activity and can be
result in serious injury or death.
I am aware of and expressly assume all inherent risks
associated with participating in this event, including, but
not limited to falls, contact with other participants, and
objects, the effects of weather, including high heat and
humidity, traffic, and the conditions of the Triathlon
course and the finish area. ______initial
IN CONSIDERATION: of your accepting this entry, I for
myself and anyone entitled to act on my behalf, waive
and release from any and all claims for injury and
damages I may have against Team Mango Races, the
Village of Kailua, Kona County, the State of Hawaii, the
United States of America, the Sponsors, Event
Volunteers, their agents and representatives caused by
negligence of any of them arising out of my participating
in this event, including pre and post-race activities. I
ATTEST that I am physically fit and have a sufficiently
trained for competition of the Monster and Mini Monster
Triathlon. ____initial
I CONSENT to receive Medical treatment which may be
advisable in the event of illness or injury suffered by me
during this event and agree to pay for the costs of my
Medical treatment. ____initial
|
SIGNATURE __________________________________________________ Date ___/___/20___
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