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WAIVER, RELEASE & INDEMNIFICATION

Please read carefully before signing and filling out form:

In consideration of my acceptance to the AMERICAN MEMORIAL TRIATHLON (“the event”):

1. I hereby agree to comply with all the rules and regulations and event instructions of the event and its directors.

2. For myself, my executors, administrators, heirs, next of kin, and assigns, I hereby:

(a) Waive and release any and all claims that I may have against the Event, its event committee, their officers, directors, members, volunteers, employees, agents, sponsors, the County of Orange, the Platt Systems, The Village of Greenwood Lake (GWL), the Town of Warwick, The Town of West Milford, GWL PBA, their officers, agents and employees, or any one of the executors, administrators, heirs, next of kin, successors or assigns (“The releases”) including any and all claims for damage caused by the negligence of any of them, arising out of my participation in the event and its related activities, together with any costs including attorney’s fees incurred as a result of any such claim whether valid or not, and

(b) Indemnify and hold harmless the releases and each of them against any such claim that I or my guest or any one of more of my executors, administrators, heirs, next of kin, successors or assigns may have or assert or against nay costs including attorney’s fees with respect thereto.

3. I hereby acknowledge that I have sole responsibility for my possessions and athletic equipment before, during and after the event, and its related activities.

4. I hereby acknowledge that this event is extremely strenuous, difficult and hazardous even under the most favorable conditions. I understand that my participation in this event carries risk of personal injury, sickness and/or death including but not limited to those caused by terrain, my physical condition, vehicular or pedestrian traffic and other participants in the event.  I understand and hereby accept these and all other risks and hazards inherent in this event and its related activities.

5. I hereby attest that I am physically fit and have sufficiently trained for this event and that a licensed medical doctor has recently verified my physical condition.

6. I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident and/or illness during the event.

7. I hereby permit the free use of my name and pictures in broadcasts, telecasts and the press as they pertain to the event.

8. I understand that parts of the course of the event will be on public roads and highways that will not be closed to vehicular and pedestrian traffic.  I fully accept the risks and hazards that this implies, including collisions and falls during my participation and I assume complete responsibility for my own actions on all highways, roads, paths and sidewalks that comprise the course.

9. I assume complete responsibility to compete on a bicycle that has been recently inspected by a reputable bicycle dealer and I will not hold anyone associated with the event liable for any accidents occurring as a result of the malfunction of my equipment.

10. I further certify that I have read and fully understand the attached Official Race Rules and the above Waiver, Release and Indemnification Form and that the contents were completely and candidly understood by me and that I am voluntarily consenting hereto.

 

  ___________________________________________________________
Print Name (legibly)

 

  _________________________________________      ____ / ____ / ____  Signature                                                                                   Date

 

  ____________________________________________________
Parent’s Signature (if under 18 years old)

 

For those not registering online, please print this page, sign the waiver above, fill out the form below and mail it to the address listed on the form below

2008 American Memorial Triathlon

Send the following to:  American Memorial Triathlon, P.O. Box 38, Greenwood Lake, NY 10925

Payment for race payable to American Memorial Triathlon
A standard (9 1/2 x 4") self-addressed stamped envelope (3 envelopes per team) to receive acceptance letter
Signed Waiver, Release & Indemnification from above. Don't forget!
For Official Use

num______________
team_____________
Name(First, Last)                                                          __Team  __ Individual

 

 Birth Date (mm/dd/yy) Sex

 ____ M      ____ F
Address

 

 Payment Enclosed

$_______________

 Age on day of race

 ________________
City                                                                        State               Zip

 

 Swimmer Name Biker Name
Phone (day)                                                        (evening)

 

 Runner Name T-shirt Size

___ M ___ L ___ XL
Occupation                                Position                             Company

 

 Teams only

_____ male    _____ female   _____ mixed

Your application has been rejected for the following reason(s): ___ failure to indicate age   ___waiver/release not signed
___failure to include late fee   ___failure to enclose self-addressed stamped envelope(s)   ___failure to include team members applications
THIS FORM MAY BE DUPLICATED - TEAM ENTRIES MUST BE SUBMITTED TOGETHER
 

Relay Teams:  Each competitor must fill out a separate application.  Team applications must be mailed in one envelope with three (3) SASE’s enclosed.