Name: Rank: Unit: Age:
DOB: Sex: Work Local: Home Number: Email:
Address: Postal Code:
Completed a Tri Before: Yes/No Sprint PB: Olympic PB:
Triathlon goal(s) for 2004:
Long-term triathlon goal(s):
What is your expectation of the NTC?
Do you already have a 2004 season training plan? Yes/No
Comments on present training schedule(Time, Type, Frequency, etc):
In order to be a member in good standing of the NTC and be eligible to take part in club events, a $25.00 ($50.00 for associate members) membership fee must be paid by cash or cheque. Cheques should be made out to the “Base Fund”. As well, the liability waiver below must be read and signed.
Waiver of Liability
In consideration of my being permitted to participate as a member of the Navy Tridents Triathlon Club, I myself, my heirs, executors, administrators, successors and assigns do hereby remise, release and forever discharge, waive and save harmless, protect and keep indemnified the organizers of Navy Tridents Triathlon Club, the Canadian Armed Forces, the Province of Nova Scotia, HRM, Triathlon Canada, Triathlon Nova Scotia, any and all clubs, associations, sanctioning bodies, sponsoring corporations, sponsors, participants, club members, entrants and all other respective agents, officials, servants and representatives from and against any and all kinds of actions, claims, costs and expenses and demands in respect to death injury, loss or damage to my person or property howsoever caused out of my being permitted to attend at or in any way take part prior to, during or subsequent to Navy Tridents Triathlon Club events whether as an entrant, competitor, participant, spectator, otherwise and not withstanding that the same may have been contributed to or occasioned by the negligence of any of the aforesaid, their agents, officials, servants, or representatives. By submitting this membership form, I acknowledge having read and agreed to the above waiver.
(Of Parent or Guardian if under 18)