Membership Registration

Warrenton Indoor Triathlon Registration Session I Jan 15 - Mar 15 2011

Complete form below to sign up the triathlon.
Full Name

First NameLast Name
E-mail:
Phone Number

Area CodePhone Number
Sex
Birth Date

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
I, the participant, intending to be legally bound, do hereby certify that I am physically fit and have not been otherwise informed by a physician. I acknowledge that I am aware of all of the risks inherent in training and competition, including possible permanent disability or death, and agree to assume all of those risks. AS A CONDITION OF MY PARTICIPATION IN THIS SESSION, I HEREBY WAIVE ANY AND ALL RIGHTS TO CLAIMS FOR LOSS OR DAMAGES, INCLUDING ALL CLAIMS FOR LOSS OR DAMAGES CAUSED BY THE NEGLIGENCE, ACTIVE OR PASSIVE, OF THE FOLLOWING: WARRENTON MASTERS SWM TEAM, FACILITY OWNER, OR ANY INDIVIDUALS OFFICIATING OR SUPERVISING SUCH ACTIVITIES. I will follow all rules of facilities used for this event.
By initialing the box below I agree to the statement above
Individual Registration

Select as many as you wish
Individual Mens Registation
Individual Women's Registration
Abs of Steel Contest? (optional)
Starting Weight (optional Abs of Steel Contest)
Men's Relay Registration

Select as many as you wish, Youngest member determines age group of relay. Two or more participants
Men's Relays
Women's Relay Registration

Select as many as you wish, Youngest member determines age group of relay. Two or more participants
Women's Relays
Mixed Relay Registration

Select as many as you wish, Youngest member determines age group. Must have at least one of each sex.
Mixed Relays
Men's Improving Relay Form
Team Name Men's Improving Relay
Men's Improving Relay Swimmer

First NameLast Name
Men's Improving Relay Biker

First NameLast Name
Men's Improving Relay Runner

First NameLast Name
Women's Improving Relay Form
Team Name Women's Improving Relay
Women's Improving Relay Swimmer

First NameLast Name
Women's Improving Relay Biker

First NameLast Name
Women's Improving Relay Runner

First NameLast Name
Mixed Improving Relay Form
Team Name Mixed Improving Relay
Mixed Improving Relay Swimmer

First NameLast Name
Mixed Improving Relay Biker

First NameLast Name
Mixed Improving Relay Runner

First NameLast Name
Men's Sprint Relay Form
Team Name Mens Sprint Relay
Men's Sprint Relay Swimmer

First NameLast Name
Men's Sprint Relay Biker

First NameLast Name
Men's Sprint Relay Runner

First NameLast Name
Women's Sprint Relay Form
Team Name Women's Sprint Relay
Women's Sprint Relay Swimmer

First NameLast Name
Women's Sprint Relay Biker

First NameLast Name
Women's Sprint Relay Runner

First NameLast Name
Mixed Sprint Relay Form
Team Name Mixed Sprint Relay
Mixed Sprint Relay Swimmer

First NameLast Name
Mixed Sprint Relay Biker

First NameLast Name
Mixed Sprint Relay Runner

First NameLast Name
Men's Full Relay Form
Team Name Men's Full Relay
Men's Full Relay Swimmer

First NameLast Name
Men's Full Relay Biker

First NameLast Name
Men's Full Relay Runner

First NameLast Name
Women's Full Relay Form
Team Name Women's Full Relay
Women's Full Relay Swimmer

First NameLast Name
Women's Full Relay Biker

First NameLast Name
Women's Full Relay Runner

First NameLast Name
Mixed Full Relay Form
Team Name Mixed Full Relay
Mixed Full Relay Swimmer

First NameLast Name
Mixed Full Relay Biker

First NameLast Name
Mixed Full Relay Runner

First NameLast Name
Men's Double Relay Form
Team Name Men's Double Relay
Men's Double Relay Swimmer

First NameLast Name
Men's Double Relay Biker

First NameLast Name
Men's Double Relay Runner

First NameLast Name
Women's Double Relay Form
Team Name Women's Double Relay
Women's Double Relay Swimmer

First NameLast Name
Women's Double Relay Biker

First NameLast Name
Women's Double Relay Runner

First NameLast Name
Mixed Double Relay Form
Team Name Mixed Double Relay
Mixed Double Relay Swimmer

First NameLast Name
Mixed Double Relay Biker

First NameLast Name
Mixed Double Relay Runner

First NameLast Name
Registration Fees
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Registration Fee $15.00

Extra Individual Events$5.00

Quantity

Relays$15.00

Quantity

Total $0.00
Payment Method
Make check payable to Warrenton Masters Swim Team

Leave in evelope at front desk at the WARF addressed to Warrenton Masters or mail to:

Warrenton Masters Swim Team

190 North View Circle Warrenton VA 20186
If you would prefer to give your credit card information over the phone for payment,
please call 540 428-2035. Otherwise please provide information below. Thank you.
Name on Credit Card

First NameLast Name
Address on Credit Card if different then above

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Credit Card Number
Expiration Month
Expiration Year
csv number (onback)
Enter the message as it's shown before submitting entry
Should be Empty:

Warrenton Indoor Triathlon Registration Session I Jan 15 - Mar 15 2011

Individual Registration

Men's Relay Registration

Women's Relay Registration

Mixed Relay Registration

Men's Improving Relay Form

Women's Improving Relay Form

Mixed Improving Relay Form

Men's Sprint Relay Form

Women's Sprint Relay Form

Mixed Sprint Relay Form

Men's Full Relay Form

Women's Full Relay Form

Mixed Full Relay Form

Men's Double Relay Form

Women's Double Relay Form

Mixed Double Relay Form

Registration Fees*

Registration Fees