Mail to:
AA Sports, Ltd.
4836 SW Western Ave.
Beaverton, OR 97005

Event (Choose One)

Individual - Triathlon & Duathlon
- Triathlon Individual - $45 (on or before July 31) Duathlon Individual - $45 (on or before July 31) Triathlon Individual - $50 (on or after August 10) Duathlon Individual - $50 (on or after August 10) Kid's Triathlon - $20 (on or before July 31) Kid's Triathlon - $25 (on or after August 10)

Relay - Two or Three Person (EACH PERSON MUST COMPLETE A SEPARATE ENTRY FORM. ALL TEAM FORMS MUST BE MAILED IN TOGETHER)
- Triathlon Relay - $30 ppr (on or before July 31) Triathlon Relay - $35 ppr (on or after August 10) Duathlon Relay - $30 ppr (on or before July 31) Duathlon Relay - $35 ppr (on or after August 10)

First Name / MI / Last Name

Street Address

City

State/Province

Zip/Postal Code

Birthdate - mm/dd/yy

Age

Gender
- Female Male
Phone

Email

Emergency Contact Name/Number

Division (Individual)

- 12 years & under 13 - 15 years 16 - 19 years 20 - 24 years 25 - 29 years 30 - 34 years 35 - 39 years 40 - 44 years 45 - 49 years 50 - 54 years 55 - 59 years 60 years & over


RELAY MUST COMPLETE*
* TRIATHLON DIVISION (Combined three ages. If two on a team, take the person who is doing two disciplines and double it)
- 105 & Under - All Men 105 & Under - All Women 105 & Under - Mixed 106 & Over- All Men 106 & Over- All Women 106 & Over- Mixed
* DUATHLON DIVISION (Combined ages.)
- 70 & Under - All Men 70 & Under - All Women 70 & Under - Mixed 71 to 90 - All Men 71 to 90 - All Women 71 to 90 - Mixed 91 & Over - All Men 91 & Over - All Women 91 & Over - Mixed
* Team Name (20 characters or less)

* Teammates Names:

Swimmer (tri)

Runner #1 (du)

Biker

Runner (tri)

Runner #2 (du)

ChampionChip Number (if applicable - Example - CE12345)

TRI NorthWest Membership # (if applicable)


Check#

Amount Enclosed


WAIVER MUST BE READ, SIGNED AND MAILED WITH ENTRY
OFFICIAL WAIVER: I acknowledge that a Multi-Sport Event is an extreme test of a person's physical and mental limits and carries with it the potential for death, series injury, and property loss. I HEREBY ASSUME THE RISKS OF PARTICIPATING IN THIS EVENT. I certify that I am capable of completing all disciplines of the event, and that I am physically fit and that I have sufficiently trained. I agree to abide by the competitive rules. I hereby take the following action for myself, my executors, administrators, heirs, next to kin, successors and assigns, or anyone else who might claim or sue on my behalf, and I hereby waive, release and discharge from any and all claims, losses, or liabilities for death, personal injury, partial or permanent disability, property damage, medical or hospital bills, or theft which may arise out of or relate to my participation in this event. I agree not to sue, and to hold harmless any and all persons, sponsors, volunteers, participants or government agencies for any and all claims or liabilities that I have waived, released or discharges herein. I further agree to return the timing Chip that is been issued to me or to pay a $30 replacement charge. The Entry Fee is Non-Refundable/Non-Transferable.

Type Full Name


Signature X ___________________________________________________________________
(Signature of Parent or Legal Guardian if participant is under the age of 18)

Date________________________________________