See "Race Schedule" Tab for Where to Mail Pre-Registration Form 

Kiwanis Kids Triathlon Series Entry Form Last Name ____________________________   First Name ________________________ Address___________________________________________________ City ______________ State ______   Zip ________  Home phone ______________  Email___________________________________________ Birth Date ____________  Racing Age (as of Dec. 31, 2008) ______  Gender: _________   Which race location? ______________________________________ (complete a separate entry for each race)   Date of race: _________________     USA Triathlon member #: _____________________ Cost: $20 pre-registration, $25 race day.  All participants must be members of USA Triathlon. One-day youth memberships are no longer available.  You may purchase an annual USA Triathlon youth membership for just $5 at www.usatriathlon.org. The participant will be asked to provide a membership number at the time of race check-in.   Waiver (All triathletes and parents must read and sign.  Please read carefully)   I acknowledge that triathlon is an extreme test of a person's physical and mental limits and carries a potential for death, injury, and property loss. I HEREBY ASSUME THE RISKS ON BEHALF OF MY CHILD OF PARTICIPATION IN THE KIWANIS KIDS TRIATHLON SERIES. I hereby certify that he/she is capable of completing all three segments, that he/she is physically fit and that he/she has sufficiently trained for this event. I agree not to sue and will hold harmless any persons, sponsors, volunteers, participants, or USA Triathlon for any and all claims or liabilities that I've waived, released or discharged herein. I hereby authorize medical treatment for any and all injuries sustained by my child during this event. I understand and take full risk on behalf of myself and said minor.   _______________________________      _________________ Participant's Signature                                       Date _______________________________      _________________ Parent/Guardian's Signature                   Date   Make checks payable to Kiwanis.  $20 pre-registration; $25 race day. Entry is incomplete without both signatures.  Entries without signatures and correct entry fee will be returned.