ATTN: CVILLE MINI TRI
P.O. Box 14
Charlottesville, VA 22902
*Limit of 100 Participants **No refunds but can transfer registration.
**Mail-In entry deadline must be postmarked 5/14
cvilleminitri@yahoo.com
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Charlottesville Mini Tri | ||||||||||||||||||||||||||
| Sunday, May 18, 2008 | |||||||||||||||||||||||||||
| Registration Form | |||||||||||||||||||||||||||
| Name_________________________________________ Phone:___________________ | |||||||||||||||||||||||||||
| Address_______________________________________ Birthdate:________________ | |||||||||||||||||||||||||||
| _______________________________________ Age on race Day:__________ | |||||||||||||||||||||||||||
| E-mail:_________________________________________ Sex: (circle) M F | |||||||||||||||||||||||||||
| Please give approximate swim time for 150 yard swim (participants without approximation will start at end of line) ____ | |||||||||||||||||||||||||||
| Circle Shirt Size: Youth S M L Adult S M L XL (size not guaranteed after 5/9) | |||||||||||||||||||||||||||
| Please send Payment (checks payable to PACEM) and registration form to: | |||||||||||||||||||||||||||
| Mail to: PACEM ATTN: CVILLE MINI TRI P.O. Box 14 Charlottesville, VA 22902 |
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| **Registration Fee: $15 postmarked by 4/18, $25 postmarked 4/19-5/9, Race Day $35 *Limit of 100 Participants **No refunds but can transfer registration. **Mail-In entry deadline must be postmarked 5/14 |
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| Waiver: I, the participant, freely accept and assume all such risks, dangers, and hazards and the possibility of personal and bodily injury or illness which may directly or indirectly result from my participation in the Charlottesville Mini Triathlon, and I further agree to save and hold Crow Pool, event coordinators, volunteers, and PACEM, harmless and agree to indemnify each of said persons/groups against all liability for loss, costs, injury or damage to persons or property which may arise by virtue of the undersigned engaging in the Charlottesville Mini Triathlon. I further state that I am in proper physical condition to participate in this event. Event Coordinators reserve the right to postpone, cancel, or modify the event due to weather conditions or other factors beyond the control of the coordinators which may affect the health or safety of the participants. | |||||||||||||||||||||||||||
| Signature:_________________________________________________ Date________________ | |||||||||||||||||||||||||||
| If under 18, Parent/Guardian Signature_______________________________________________ | |||||||||||||||||||||||||||
| Questions? Need to transfer a registration? Please contact Samantha Jones at cvilleminitri@yahoo.com |
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