Shadehill Sprint Triathlon

Sponsored by

Lemmon Sports Boosters

Name____________________________________________________ Home Phone______________________________________________ Address__________________________________________________ City_____________________________________________________ State__________________________ Zip_______________________ Email Address______________________________________________ Male ( ) Female ( ) Age______________ Age Group 14-19 ( ) 20-29 ( ) 30-39 ( ) 40-49 ( ) 50+ ( ) Team ( ) Members: ___________________________________ ___________________________________ T-shirt size______________________________________________ Est. 400 meter swim time _______________ (beginners leave blank)

What : Open Swim Sprint Triathlon When:

Saturday August 17th

Pre-Race Meeting 9:00 am Race Time 10:00 am SHARP Kids Tri (13 and under) Noon-or following the Tri

Where: Shadehill Reservoir

(12 miles south of Lemmon, SD)

Cost:

$30 Ind. ($35 after August 1st) $45 Team ($50 after August 1st) $5 Kids ($10 after August 1st)

Race Release:

*****HELMETS REQUIRED*****

Make Checks payable to: Lemmon Sports Boosters 116 Main Ave. Lemmon, SD 57638

In consideration of Lemmon Sports Boosters furnishing services to enable me to participate in the Shadehill Sprint Triathlon, I agree as follows: I, on behalf of myself, my personal representatives and my heirs, hereby voluntarily agree to release, waive, discharge, hold harmless, defend and indemnify Lemmon Sports Boosters and its agents, sponsors, officers, and volunteers from any and all claims, actions or losses for bodily injury, property damage, wrongful death, loss of services, or otherwise which may arise out of my participation in the Shadehill Sprint Triathlon/Kids Tri, I specifically understand that I am releasing, discharging and waiving any claims or actions that I may have presently or in the future or negligent acts or other conduct by the agents, sponsors, officers or volunteers of Lemmon Sports Boosters. This waiver is good through 8/31/13. (Participant Signature) (Parent/Guardian Signature) (Date) (Date)