Roaring Fork Women's Triathlon Team Application & Data Sheet 2017
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First Name *
Your answer
Last Name *
Your answer
Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Preferred Phone Number *
Your answer
Email *
Your answer
Age *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Occupation *
Your answer
Days I work *
Your answer
Physician's Name *
Your answer
Date of last heart and lung exam *
MM
/
DD
/
YYYY
Emergency Contact's Name *
Your answer
Emergency Contact's Phone Number *
Your answer
T-shirt Size *
Sock Size *
Shoe Size *
Your answer
Height *
Your answer
Weight *
Your answer
I work out... *
I have a health challenge, yes or no. *
If you answered "Yes" above, please explain.
Your answer
Swim experience: Triathlon training requires basic freestyle swim skills. How well can you swim? See Swim Questionnaire and also answer the following: *
Bike Experience: *
What type of bike do you prefer?
Walk Experience (if you will RUN, skip this section)
Run Experience (if you will WALK, skip this section)
5K Experience *
If you've completed a 5K, what was your best time?
Your answer
Triathlon Experience: *
If you've completed multiple triathlons, please give the numbers of each distance you've completed. (Example: 5 sprints, 1 olympic):
Your answer
Please explain why you want to take this triathlon training class: *
Your answer
Membership: please check applicable option below (Payable in full via www.active.com) *
Required
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