ࡱ> @ "jbjbܡܡ R"l,@           ,, L+      +     R        Di\  @ @ ,   2006 TINMAN TRIATHLON ENTRY FORM (Please PRINT Clearly)  Last Name ((((((((((((((((((( First Name ((((((((((((( Birthdate ((-(( -(( Age (on 7/23/06) (( Sex (M (F First Tinman Triathlon? ______ Address ((((((((((((((((((((((((((((((((((( City ((((((((((((((( State (( Zip Code ((((( Country ((((((( Phone ((( ((((((( email (((((((((((((((((((((((( Division : Elite ( or Age Group ( or Team ( or Wheelchair ( Individual Team For Team entrants, please check: Male( Female( Co-Ed ( until 5-23-06 $80 $100 Teams: Enclose separate entry forms for each team member in a single envelope until 6-13-06 $100 $120 Tinman T-Shirt (included with fee, please circle size) S M L XL XXL until 7-10-06 $115 $140 Optional Finisher Mail entry form and fee to: Tinman Unlimited Crew-neckT-shirt $15 S M L XL XXL c/o The Bike Shop Total amount enclosed: $___________ 1149 South King Street Honolulu, HI 96814 Make check or money order payable to: Tinman Unlimited Read and sign statement below: ACCIDENT WAIVER AND RELEASE OF LIABILITY I acknowledge that this athletic event is an extreme test of a persons physical and mental limits and carries with it the potential for death, serious injury and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of athletes, equipment, vehicular traffic, actions of other people including but not limited to, participants, volunteers, spectators, coaches, event officials, and event monitors, and/or producers of the event, and lack of hydration. These risks are not only inherent to athletes, but are also present for volunteers. I hereby assume all of the risks of participating and/or volunteering in this event. I realize the liability may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned maintained or controlled by them or because of their possible liability without fault. I certified that I am physically fit, have sufficiently trained for participation in the event and have not been advised otherwise by a qualified medical person. I acknowledge that this Accident Waiver and Release of Liability form will be used by the event holders, sponsors and organizers, in which I may participate and that it will govern my actions and responsibilities at said events. In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, Release and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter occurs to me including my traveling to and from this event, THE FOLLOWING ENTITIES OR PERSONS: City and County of Honolulu, the State of Hawaii, Tinman Unlimited, their directors, officers, employees, volunteers, representatives, and agents, the event holders, event sponsors, event directors, event volunteers; (B) Indemnify and Hold Harmless the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this event, whether caused by the negligence of releasees or otherwise. I hereby consent to receive medical treatment, which may be deemed advisable in the event of injury, accident and or illness during this event. I understand that at this event or related activities, I may be photographed, I agree to allow my photo, video or film likeness to be used for any legitimate purpose for the event holders, producers, sponsors, organizers and or assigns. This Accident Waiver and Releases of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I hereby certify that I have read this document; and, I understand its content. _____________________________________________________________________ _______________________________________________________________________ PLEASE PRINT Participants Name Age Signature of participant Date (if under 18 years old, parent or guardian must also sign; see below) PARENT GUARDIAN WAIVER FOR MINORS (Under 18 years old) The undersigned parent and natural guardian or legal guardian does hereby represent that he/she is, in fact, acting in such capacity and agrees to save and hold harmless and indemnify each and all of the parties referred to above from all liability, loss, cost, claim or damage whatsoever which may be imposed upon said parties because of any defect in or lack of such capacity to so act and release said parties on behalf of the minor and the parents or legal guardian. _____________________________________________________________________ _______________________________________________________________________ PLEASE PRINT Parent or Guardian Name Age Signature of Parents or Guardian Date 0Qf  ʻʲ~~ui~ui~u]~TCJOJPJQJ jCJ$OJPJQJ jCJ$OJPJQJCJ$OJPJQJ j.CJ$OJPJQJCJ OJPJQJ j/CJ$OJPJQJ j;CJ$OJPJQJ OJPJQJCJOJPJQJja5CJOJPJQJU5CJOJPJQJ5CJOJPJQJ5OJPJQJj5CJOJPJQJU5CJOJPJQJ ?y& n U  y z $1$7$8$H$^a$$ 1$7$8$H$^ a$$ & F1$7$8$H$a$p1$7$8$H$^p`01$7$8$H$^`01$7$8$H$ `1$7$8$H$]`?y& n U  y z aGveYa\!"g    '  >?FTUVxy𬠸Ҭ۠𔠋ҁ5CJOJPJQJCJOJPJQJ jCJ$OJPJQJ j/CJ$OJPJQJ jCJ$OJPJQJCJ OJPJQJ!CJOJPJQJehrCJOJPJQJCJ$OJPJQJ j.CJ$OJPJQJ OJPJQJCJOJPJQJ1(*+,/3567:FGc % + 0 1 3 z Żűű⥒Œʼn5CJOJPJQJCJOJPJQJ>*CJOJPJQJCJ$OJPJQJ j.CJ$OJPJQJ5CJOJPJQJ>*CJOJPJQJCJOJPJQJ>*CJOJPJQJ5CJOJPJQJCJOJPJQJCJOJPJQJ jCJOJPJQJ2    & m n # 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