First Name:

                  Address:

                        City:

                       State:

                           Zip:

                     Gender: Choose One Male Female

               Birth Date:

  Age On Event Day:

                       Phone:

                        Email:

                         Event: Choose One Sprint Olympic

                   Shirt Size: Choose One Small Medium Large X Large XX Large

LIABILITY WAIVER:

If the waiver is not signed the registration will not be accepted

PARTICIPANT hereby covenants not to sue RELEASEES and fully and forever releases, waives, and discharges RELEASEES from all liability. PARTICIPANT agrees to assume all responsibility for all loss(es) or damage(s) and any and all claims or demands therefore, on account of injury to PARTICIPANT or property or resulting in the death of PARTICIPANT, whether caused by the active or passive negligence of all or any of RELEASEES or otherwise, in connection with PARTICIPANT'S participation in the race. PARTICIPANT fully understands and is aware of all potential risks, accidents, injuries, and adverse health consequences in participation during the Blacktail Triathlon. PARTICIPANT agrees not to participate against medical advice or with any knowledge of health conditions that would place PARTICIPANT at special risk by participating. PARTICIPANT agrees to cease participation and seek assistance if adverse health symptoms develop before/during/after participation. RELEASEES encourage and warn PARTICIPANT to not use any type of personal music device and headphones during participation. PARTICIPANT hereby assumes all responsibility for any outcomes or legal issues that arise from the use of such equipment during the race. PARTICIPANT agrees not to use or encourage the use of the following items on the race course: rollerblades, unauthorized bicycles, dogs or animals, joggers/strollers, scooters, skateboards, and any other device that may endanger the other participants or put PARTICIPANT at an advantage over the other participants. PARTICIPANT fully and forever gives permission to the Blacktail Triathlon and its assignees to reproduce or use my image or video without cost or reimbursement, on video, photographic, or any other media, for race products and/or promotional purposes. PARTICIPANT acknowledges that the entry fee is non-refundable in any way and that 50% of entry fees may be transferable to other PERSONAL BEST Performance races during the same calendar year; any increased differences will be paid by PARTICIPANT. RELEASEES reserve the right to cancel, delay, or prevent the race from taking place by reason of fire, heat, flood, lightning, hurricanes, tornadoes, earthquakes, public disaster, unavoidable casualty, or any other cause beyond the control of RELEASEES; upon cancelation, there shall be no refund of the entry fee or any other costs of PARTICIPANT in connection with the race. PARTICIPANT understands that PARTICIPANT will receive a rental timing chip; PARTICIPANT agrees to return the timing transponder and its attachment device to an appropriate race official after the race. If PARTICIPANT fails to do so, PARTICIPANT agrees to pay PERSONAL BEST Performance $100.00 to replace the timing transponder and attachment device. PARTICIPANT (undersigned PARTICIPANT, parents, guardians, personal representatives, assigns, heirs, and executors) RELEASEES (Blacktail Triathlon, PERSONAL BEST Performance, Foothills Rehabilitation, County of Bonneville, City of Idaho Falls, Idaho Falls Police Department. Idaho Transportation Department, Bonneville County Sheriff's Office, Idaho State Police, all municipal agencies whose property and/or personnel are used, and all other sponsoring companies/individuals related to the race.)

  
                                          Waiver: Choose One Yes

                                      Signature:

Parent Or Guardian If Under 18:

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